' 



Century Book of Health 



THE MAINTENANCE OF HEALTH 
PREVENTION AND CURE OF DIS- 
EASE ■ MOTHERHOOD ■ CARE 
FEEDING AND DISEASES OF 
CHILDREN • MODERN HOME 
NURSING • ACCIDENTS AND EMER- 
GENCIES-INJURIOUS HABITS 
A COMPLETE PRACTICAL GUIDE 



BASED UPON THE LATEST MEDICAL PRACTICE 

RECENT DISCOVERIES IN SCIENCE 

AND U. S. PHARMACOPOEIA 

REVISION OF 1905 



J. H. McCORMICK, M.D., Editor-in-Chief 

Member: American Therapeutical Society, Medical Society of the District of Columbia, Medical 
Association of the District of Columbia, Medical and Surgical Society, Wash- 
ington, D. C, Anthropological Society, Biological Society 
Maryland Public Health Association 



The King-Richardson Company 

SPRINGFIELD, MASS. BUFFALO, N. Y. CHICAGO, ILL. 



.Hi*s 



COPYRIGHT BY 

THE KING-RICHARDSON COMPANY 
1906 



COPYRIGHT BY 

THE KING-RICHARDSON COMPANY 
1907 



COPYRIGHT BY 

THE KING-RICHARDSON COMPANY 
1908 



COPYRIGHT BY 

THE KING-RICHARDSON COMPANY 
1909 



COPYRIGHT BY 

THE KING-RICHARDSON COMPANY 
1912 



gCU3l24*3 

Kin i 



EDITOR IN CHIEF. 






john h. Mccormick, m.d. 

Member : American Therapeutical Society, Medical Society of the District of Columbia 

Medical Association of the District of Columbia, Medical and Surgical Society 

Washington, D.C., Anthropological Society, Biological Society 

Maryland Public Health Association 



ASSOCIATE EDITORS. 

i 
GEORGE R. DEVITT, A.B. 

Member : Anthropological Society : National Geographical Society 

Literary and Managing Editor 



James Freed Wark, D.D.S. 

Western Reserve University, Superintendent of 
Dental Clinic 

" Hygiene and Care of the Teeth' ' 



G. Frederic Wheeler 

Mills Training School for Nurses, Expert Nurse 
and Masseur 

"Nursing" and "Massage" 



J. W. Woods, M.D. 

Medical College of University of New York 

Sometime Attending Physician Midwifery 

City of New York, Attending Physician 

Diseases of Children, Northwestern Hospital 

" Care, Feeding, and Diseases of 
Children" 



J. W. Hofsess, M.D.,D.O. 

Sometime Dean S.S. Still College 
of Osteopathy 

" Principles of Osteopathy" 



Gordon Lindsay, Ph.G.,B.S.,M.D. 

Bellevue Medical College, New York 

Staff of Bellevue and Allied 

Medical Hospitals 

" Causation and Prevention of Disease" 



Emil Buehler, Ph.G. 

New York College of Pharmacy 

Dispensing Pharmacist Northwestern Hospital 

New York City 

"Materia Medica" and "Useful 
Medical Knowledge" 



R. W. Conant, A.B.,M.D. 

Yale University, Chicago Homcepathic College 

"Domestic Hygiene" 

"Alcoholism" 

"Injurious Habits and Their Effects' 

"Drug Frauds" 

etc. 



R. J. McDonnell, M.D. 

Rush Medical College 

" Accidents and Emergencies" 
A. Goltman, M.D. 

McGill Medical University 
L.R.C.P. and L.R.C.S., Edinburgh 

L.F.P., Glasgow 
Consulting Oculist, New York City 

" Hygiene of the Eye and Ear" 



Charles H. Clemmer, M.A. 

State Institute Conductor of Teachers' Institutes 

"Anatomy and Physiology" 



INTRODUCTION. 

By JOHN H. McCORMICK, M.D. 

The study of medicine, not as an accomplishment, but as a subject 
of the first importance to the individual, should be taken up by every one. 
The care of our bodies is our first duty to ourselves. " Self-preservation 
is the first law of Nature." In obedience to that law all should learn 
from undoubted authorities how to preserve a healthful condition of 
body, to ward off disease, to care for and to feed the sick, as well as to 
render aid to the injured in emergencies. The need of this study is all 
the more emphasized by the statement upon the highest medical author- 
ity that nearly all of our ailments are produced and propagated by either 
our own ignorance or our own carelessness. 

At no period of the world's history have the people been so well quali- 
fied to take up the study of health as they are now. Physiology and 
other science subjects, taken up of late years in the schools of the country, 
have given a solid foundation upon which a sound knowledge of the 
human body and its needs may rest. This fact and the wonderful 
advances in medical science require that the subject be approached in a 
very different way from that which satisfied our immediate ancestors. 
Ten years have made a wonderful change in our knowledge of health 
and disease. Treatises that were excellent in their day now fail to meet 
the new conditions in so many respects that new and revised editions no 
longer satisfy. 

The study of medicine is not limited, as so many think, to the heal- 
ing of the sick. It is a many-sided science; in fact, it levies tribute 
upon all sciences, and, like the honeybee, takes what it needs from all 
of the flowers in the garden of knowledge. One of its most important 
aspects is the prevention of disease, which every one can practise to his 
own and his family's great welfare. This means much more than to 



io INTRODUCTION. 

merely abide by the laws and regulations of boards of health and city 
ordinances. 

A parent who can train the sons and daughters of the family to 
right habits of life and the practice of daily personal hygiene, confers 
upon them the inestimable blessing of a magnificent start in life. When 
by these means the predisposing causes of disease are removed, or at 
least modified, the children are passed safely through the numerous evils 
incident to childhood and youth. 

The mother who performs the highest act of life — the conferring of 
life itself upon her child — needs much more than mere maternal instinct 
to guide her in the rearing of her child. However much we may be 
tempted to admire that unerring quality in the lower animals, we know 
that safe rules and guides are necessary to secure to a child its first right 
of being well born and, second, of being properly developed. 

Mothers cannot "know too much. They go forward into an undis- 
covered country, and may at any moment meet with strange conditions 
of health and disease with which they are compelled to deal, and the most 
loving and conscientious mother must pay the same penalty for her 
ignorance that others pay for willful neglect. 

In seasons of epidemic or of ordinary exposure to contagious disease, 
every one should know the proper preventive measures to be taken to 
ward off an attack. Sitting in quiet ignorance on such occasions is more 
than an error ; it is a crime. For not only is the individual himself likely 
to suffer, but he is a means of passing the disease along and of commu- 
nicating it to others. 

Only those whose knowledge of nursing and of cooking for the sick 
qualifies them to minister to the comfort of their loved ones when they 
are ill, know the joy of efficient personal attention and the flood of 
sympathetic care which often works magic in the cure of a disease. 
What a sense of disappointment and loss of self-confidence is felt when 
on such occasions we realize our ignorance of the right thing to be 

"These hard, well-meaning hands we thrust 
Among the heartstrings of a friend." 

And yet how comparatively easy this knowledge is of acquisition and 



INTRODUCTION. II 

what a power for good it makes of its possessor. How we are forced 
to admire the calm, direct effort of the one who knows just what to do 
in emergencies and accidents; while the ignorance of helpful measures 
causes panic and helpless confusion in others. "Knowledge is power" 
undoubtedly on such occasions, and very often it has been the power 
of saving life when out of reach of a doctor's aid. 

Why do not people generally know as much about these things as 
they do about some others? Why do they not know more about medi- 
cine than they do? Ignorance of the subject not only exposes them to 
the ravages of disease; and deprives them of the joy of caring for their 
loved ones when ill ; but, worst of all, it exposes them to the cruelty and 
robbery of the quack and charlatan, because they have not the power of 
knowing the impostor and incompetent from the trustworthy and skilled. 

The medical fraternity are not to be expected to teach people this 
knowledge. Theirs is a profession and one of hard work. They have 
not the time to give such instruction to their patrons, and it is not to be 
expected from them. It must be derived from other sources. 

The labor attached to the gathering together of matter from so many 
sources; of subjecting it to modern criticism; of arranging to the best 
advantage what would prove most helpful, — has been a task of no slight 
magnitude. That, however, has been forgotten when it is remembered 
that we have the honor of presenting a work that is at once reliable in its 
recommendations, trustworthy in its advice, and clear and plain in its 
instructions and explanations. 

There are many new features incorporated in this work which we 
feel are of especial value. Not the least of these is the Materia Medica, 
where the drugs and medicines alluded to in the body of the work are 
explained as to their origin, effects, and doses. It has been insisted 
upon on the ground that the reader of this book is an intelligent person, 
and should know exactly what is being done when medicine is given. 

The copious topical index, and the emergency index for consulta- 
tion in accidents and sudden illness, have been prepared with especial 
regard for quick reference. 

We have no apology to make for the explanation of the treatment 



12 INTRODUCTION. 

of disease by the homeopathic methods, nor by the methods of the older 
school. Nor have we any to make to either of these schools for the 
explanation of the principles of osteopathy and other special systems. 
Our aim has been to give to the reader an intelligent idea of what all 
are doing, with a view to the treatment of disease and the alleviation 
of the sufferings of mankind. 

The work is mainly educative. For both general reading and study, 
the subjects of the book have been arranged in the order in which each 
should be taken up. The study proceeds from the known to the unknown 
in the order in which it will prove most helpful to those who take it up. 
There are some chapters which are to be carefully studied in detail for 
the information which will be of service in emergency and illness. The 
work is not alone for consultation in times of distress and danger. It is 
for reading and study by all of the members of the family in health that 
they may wisely avoid the errors of daily life; and in cases of illness, 
that each may contribute something, according to his ability, to relieve 
the suffering. 



TABLE OF CONTENTS 

Page 

Introduction 20 



BOOK I. 
THE MAINTENANCE OF GOOD HEALTH. 

Personal Hygiene 25 

Hygiene and General Care of the Digestive Apparatus, 26 — Food, 26 — 
Selection of Food, 27 — Rapid Eating, 27 — Irregular Meals, 27 — Moderation 
in Eating, 28 — Overeating, 28 — Deficiency of Food, 29 — Classification of 
Food, 29 — Nitrogenous Food, 29 — Fats, 30 — Carbonaceous Foods, 30 — Min- 
eral Matter, 30 — General Principles of Diet, 30 — Milk an Ideal Food for 
Children, 31— Need of Well Balanced Diet, 31— Value of Foods, 32— Table 
of Food Values, 32 — Digestibility of Food, 32 — Table of Digestibility of 
Food, 33 — Arranging a Diet, 34 — Diet Governed by Climate, 34 — Diet Gov- 
erned by Age, 35 — Diet Governed by Occupation, 35 — Change of Conditions, 
35 — Pure Food, 36 — How to Detect Impure Food, 36 — Unripe Fruit, 40 — 
Constitution and Temperament, 40 — Good Cooking, 41 — Abstinence, 41 — ■ 
Concentrated Foods, 41 — Daily Ration in Health, 42 — The Water We 
Drink and Its Effects, 42 — Impurities of Drinking Water, 43 — Effects 
of Impurities in Water, 44 — Tests for Drinking Water, 44 — To Purify 
Water, 45 — Mastication and Insalivation, 46 — Care of the Teeth, 47 — Struc- 
ture of Teeth, 48 — Causes of Decay, 49 — Cleaning the Teeth, 49 — Dead 
Teeth, 50^ Filling Teeth, 50. 

Care of the Skin, Complexion, Hair, and Nails 50 

The Skin and Its Functions, 50— Baths and Bathing, 51— Cold Bath, 51— 
Warm Bath, 52— Sea Bathing, 52— Turkish Bath, 53— Hot Bath, 53— Shower 
Bath, 53 — How to Make a Homemade Shower Bath, 53 — Bath Thermometer, 
54 — Russian Bath, 55 — Sponge Bath, 55 — Bath Room Accessories, 55 — Soap, 
56 — Face Cloths, 56 — Flesh Brush, 56 — Face Brush, 56. 

The Complexion, 56 — Cream for Pimples, 57 — Summer Rash, 57 — Freckles, 
57 — Permanent Freckles, 58 — Chapping, 58 — Tan and Sunburn, 59 — Black- 
heads, 59— Wrinkles, 60— Warts, 61. 

Clothing, 61 — Tight Neckwear, 64 — Hardening Children, 64 — Too Much Cloth- 
ing, 65 — Exercise and Food, 65 — Tight Waist Clothing, 65. 

Care of the Hair, 65 — Color of the Hair, 66 — Cleanliness, 66 — Dandruff, 67 — 
Ventilation of the Hair, 68 — Friction and Massage of the Scalp, 69 — Itching 
of the Scalp, 70— Falling Hair, 70— Gray Hair, 72— Bleaching the Hair, 73— 
Superfluous Hair, 73. 



14 TABLE OF CONTENTS. 

Care of the Nails, 74 — Manicuring, 75 — Rose Paste for the Nails, 77 — Powder 
for Polishing the Nails, 77. 

Hygiene and General Care of the Organs of Respiration and of the 
Voice 77 

Protection Against Cold, 77 — Vocal Cords, 78 — Nose Breathing, 79 — Dan- 
gerous Occupations, 79 — Cold Water Application, 79 — Bad Sitting Position, 
80 — Bad Sleeping Position, 81 — Correct Standing Position, 81 — Flat Chests 
and Round Shoulders, 82 — Exercises to Correct and Prevent Deformities, 
82 — Importance of Fresh Air and Ventilation, 85 — Diseases Caused by 
Impurities in the Air, 86 — Effects of Some Impurities in the Air, 86 — 
Amount of Fresh Air Required, 86 — Testing the Purity of the Air, 87 — 
Effects of Breathing Bad Air, 87— How to Ventilate, 88— How to Breathe 
Properly, 89. 

Care of the Nose 91 

Cleanliness, 91 — Cold in the Head, 92 — Mouth Breathing, 92 — Polypus of 
the Nose, 92 — Hairs of the Nose, 93 — Blowing the Nose, 93 — Atomizers and 
Douches, 93 — Foreign Substances in the Nose, 93. 

Care of the Ear 94 

Cold in the Ear, 94 — Wax of the Ear, 94 — Hardened Wax in the Ear, 95— 
Noises in the Ear, 95 — Deafness in Children, 95 — Boxing a Child's Ear, 
96 — Foreign Bodies in the Ear, 96 — Tests of Hearing, 96 — Helps to Hear- 
ing, 98. 

Care of the Eyes 99 

Children's Eyes, 99— Need of an Oculist, 99— Defects of Vision, 99— Test- 
ing the Eyesight, 101 — Protection of the Eyes, 102 — Poor Light, 103 — Strong 
Light in the Eyes, 103 — Care During Convalescence, 103 — Fine Print, 104 — 
Reading on Trains, 104 — Fine Work, 104 — Floating Specks, 104 — Need of 
Resting the Eyes, 105 — Bathing the Eyes, 105— Foreign Substances in the 
Eyes, 105. 

Care of the Bones 106 

Curvature of the Spine, 107 — Bones of the Feet, 107 — Cracking the 
Knuckles, 107— The Bones During Old Age, 108— Ligaments, . 108— Diseases 

and Injuries of the Bones, 108. 

Care of the Muscles 109 

Exercise, 109— Special Value of Exercise, 110— Quantity of Exercise, 113 — 
Form of Exercise, 113— Walking, 114 — Running, 116— Physical Exercise 
for Young Persons, 116 — Bicycling, 121. 

The Nervous System I 2 * 

Sleep, 121 — Neurasthenia or Nervous Prostration, 122 — Overwork, 123— 
Anger and Passion, 124 — A Stock of Energy, 125. 



TABLE OF CONTENTS. 15 

Domestic Hygiene and Healthful Homes 126 

Location, 126 — The Suburbs, 126 — Flats versus Houses, 127 — Skin Flats, 
127— The Best Way, 127— The Country House, 128— Soil, 129— The Cellar 
Walls, 129— The House Walls, 130— The Roof, 130— Water Near the 
House, 130— Sewage, 130— Dry Earth Closet, 131— The Rubbish Pile, 131 — 
Water Supply, 132 — The Grounds, 132 — The Interior, 133 — Stairways and 
Halls, 133— The Roof Garden, 133— Every Room Bright, 134— Hard Oiled 
Floors, 13-1 — House Cleaning, 134 — Prevention of Dust, 134 — The Playhouse, 
135 — The Kitchen, 135 — Cleanliness, 135 — The Bath Room, 136 — Ventila- 
tion, 136 — Impurities of Air, 137 — Tests of Air, 137 — Ventilation Problems, 
137 — Carbon Monoxide, 138 — Moisture, 138 — Heating, 138 — Furnaces, 138 — 
Early Fires, 139 — Fireplaces and Grates, 139 — Regulation of Temperature, 
140 — Automatic Regulation, 140 — Lighting, 141 — Gas, 141 — Incandescent 
Gas Light, 142 — Acetylene Light, 142 — Gasoline Generators, 142 — Position 
of Lights, 143 — Acclimitization, 144 — Diseases Due to Climate, 144. 



BOOK II. 
THE CAUSATION AND PREVENTION OF DISEASE. 

Causation of Disease in General 145 

Predisposing Causes to Disease, 146 — Age, 146 — Sex, 147 — Heredity, 147 — 
Hygienic Conditions, 148. 

Exciting Causes of Disease, 148 — Mechanical Causes, 148 — Physical Exciting 
Causes, 149 — Chemical Exciting Causes, 149 — Vital Exciting Causes, 149. 

Contagion, 149 — Nature of the Contagia, 150 — Bacteria, 150 — Mode of Entrance 
into the Body, 151 — Action within the Body, 151 — Exit from the Body, 
152 — Existence Outside of the Body, 152 — Modes of Transmission, 152. 

General Rules for the Prevention of Infectious Diseases 15.2 

Special Preventive Measures Against Infectious Diseases, 15-! — Smallpox, 
154 — Chicken Pox, 15-1 — Measles, 154 — German Measles, 15-1 — Scarlet Fever, 
15-4 — Typhus Fever, 155 — Influenza or Epidemic Catarrh, 155 — Whooping 
Cough, 155 — Mumps, 155 — Diphtheria, 155 — Typhoid Fever, 155 — Yellow 
Fever, 156 — Cholera, 156 — Dysentery, 156 — Malarial Fevers, 156 — Erysip- 
elas, 157 — Septicaemia or Blood Poisoning, 157 — Tetanus or Lockjaw, 157 — 
Hydrophobia or Rabies, 157. 

Disinfection, 158 — Fresh Air, 158 — Heat, 158 — Sterilization and Pasteurization 
of Milk, 159. 

Chemical Disinfectants, 160 — Corrosive Sublimate, 160 — Carbolic Acid, 161 — 
Formalin, 161 — Formaldehyde, 161 — Chlorine, 162 — Sulphurous Acid, 162— 
Quicklime, 162 — Permanganate of Potash, 162. 



i6 TABLE OF CONTENTS. 

Practical Disinfection, 163 — Discharges from the Mouth and Nose, 163 — Dis- 
charges through the Skin, 163. 

Disinfection of Clothing and Bedding 164 

Disinfection of Rooms and Furniture 164 

Modern Methods of Preventing and Curing Consumption 165 

Ravages of Consumption, 166 — What Consumption is Now Known to Be, 
166 — How Consumption is Spread, 167 — Persons Most Likely to be Attacked, 
169 — How Consumption May Be Prevented, 171 — How Consumption Begins : 
Early Symptoms, 173 — Modern Methods of Curing Consumption, 178 — Diet, 
181— Exercise, 182— How to Live Out of Doors, 183— Shelter, 183— Cloth- 
ing, 184 — Sleeping Out of Doors, 186. 

Detection and Recognition of Disease 187 

Prodromal Symptoms or Warnings of Disease, 189 — General Appearance, 
189 — The Face, 190 — The Tongue, 191 — The Gums and Lips, 191 — The Eye, 
192— The Pulse, 192— Diseases of the Heart, 193— Breathing, 194— Coughs, 
195— Expectoration, 196— The Skin, 197— The Stomach, 198— Vomit, 198— 
The Bowels, 198 — The Faeces, 199 — The Urine, 200 — Congestion of the 
Kidney, 201— Dropsy, 202— Fluctuation, 202— Seat of Pain, 202— Some 
Common Diseases and Their Symptoms, 203 — Fevers, 203 — Typhoid, 203 — 
Pneumonia, 204— Measles, 204— Scarlet Fever, 204— Tonsilitis, 205— Diph- 
theria, 205 — Jaundice, 205 — Appendicitis, 205. 

List of Symptoms Arranged for Ready Reference 206 

Table of Symptoms of Eruptive Fevers 223 



BOOK III. 
MODERN NURSING AND CARE OF THE SICK. 

Home Nursing 225 

How to Prepare the Bed, 226 — How to Pin the Sheet, 226 — How to Change 
the Sheet with the Patient in Bed, 227 — Bedsores, Prevention and Manage- 
ment, 228— How to Turn a Patient in Bed, 229— Packs, Hot and Cold, 230— 
Brand's Bath for Typhoid Fever, 231 — Bandages, 232 — Stupes, 234 — Ene- 
mata, 234 — Hypodermic Injections, 236 — Counter-Irritation, 236 — Blisters, 
237— Cupping, 238 — Leeches, 238 — Cataplasms or Poultices, 239 — Swabs and 
Mouth Washing, 241 — Ice Bag, 241 — Embrocations or Liniments, 241 — 
Endermic Medication, 242 — Nasal Douche or Spray, 242 — Necessary Uten- 
sils, 243— The Chart and How to Keep It, 244— Clinical Thermometer, 248— 
The Pulse, 248— The Respiration, 249— Medication, 249— The Urine, 251— 
Faeces, 251 — Baths, 251 — Cleanliness, 254 — Applications of Heat and Cold, 
256 — Fever Nursing, 257 — Surgical Nursing, 260 — Care of Children, 261 — 
Visitors, Flowers, etc., 262 — What Not to Do in the Sick Room, 263— 
Convalescence, 265, 



TABLE OF CONTENTS. 17 

Massage 266 

Introduction, 266 — Its Uses and Benefits, 267 — When to Give Massage, 267 — 
Importance of a System, 269 — How to Give Massage, 270 — Massage for 
Sprains and Bruises, 272 — Beauty Massage, 272 — To Massage the Face, 
274 — How to Develop the Neck and Chest, 276 — To Make the Hands and 
Arms Beautiful, 277. 

Food for the Sick : How to Prepare and Serve It 277 

Dietetics, 277 — Service of Food to the Sick, 279 — Time of Feeding, 280 — 
Assistance to a Patient While Eating, 280 — Fever Diet, 281 — Dyspepsia 
Diet, 281 — Constipation Diet, 282 — Diarrhoea, 282 — Liver Troubles, 283 — ■ 
Diabetes, 283— Bright's Disease, 284— Debility, 284— Obesity, 285— Rheu- 
matism, 286 — Gout, 286 — Consumption, 287. 

Dishes for the Sick 287 

Peptonized Foods, 287 — Soups, 293 — Farinaceous Foods, 295 — Eggs, 299 — 
Desserts, 301. 

BOOK IV. 
DISEASES OF ADULTS. 

Local Diseases of Adults 303 

Diseases of the Head, 303 — Dandruff or Seborrhcea, 303 — Baldness or Alo- 
pecia, 304 — Partial Baldness or Alopecia Areata, 306 — Neuralgic Headache 
or Tic Douloureux, 306 — Migraine or Sick Headache, Bilious Headache, 
or Blind Headache, 307 — Rheumatic Headache, 308 — Congestive Headache, 
309 — Periodic Headache, Brow Ache or Brow Ague, 309 — Organic Head- 
ache, 310 — Headache of Neurasthenia or of Nervous Debility, 310 — Head- 
ache of Eye-Strain, 310 — Anaemic Headache, 310 — -Headache Due to Diseases 
of the Kidney, 310 — Ringworm of the Scalp or Tinea Tonsurans, 311 — 
Barber's Itch or Ringworm of the Beard, 312. 

Diseases of the Eyes, 313 — Granular Lids or Trachoma, 313 — Stye or Horde- 
olum, 314 — Watery Eye, 315 — Blear Eye, 315 — Weakness of the Eyes, 316 — 
Inflammation of the Eyes or Conjunctivitis, 316 — Gonorrhceal Inflammation 
of the Eye, 317 — Aborted Stye or Chalazion, 317 — Inflammation of the 
Edge of the Eyelids or Blepharitis, 318 — Cataracts, 318 — Eye Bruises or 
Black Eye, 319 — Protrusion of the Eyeball or Exophthalmos, 320 — Sinking 
of the Eyeball, 320 — Squint or Strabismus, 320. 

Diseases of the Ear, 322 — Earache or Otalgia, 322 — Inflammation of the Ear 
or Otitis, 323 — Eczema of the Ear or Tetter, 324 — Wax in the Ear, 325— 
Foreign Bodies in the Ear, 325 — Polypus of the Ear, 326 — Noises in the 
Ear, 327. 

Diseases of the Nose, 327 — Cold in the Head or Coryza, 327 — Chronic Nasal 
Catarrh, 328 — Inflamed and Ulcerated Nose, 329 — Nosebleed or Epistaxis, 
330 — Polypus of the Nose, 331 — Foreign Substances in the Nose, 331 — Cold 
Sore, Fever Sore or Herpes, 332. 



i8 TABLE OF CONTENTS. 

Diseases of the Mouth, 332 — Chapped or Cracked Lips, 332 — Salivation or 
Mercurial Stomatitis, 333 — Gumboil, 333 — Stammering, 333 — Sore Tongue, 
33-1 — Inflammation of the Tongue or Glossitis, 334. 

Diseases of the Throat, 335 — Sore Throat or Acute Pharyngitis, 335 — Clergy- 
man's Sore Throat or Chronic Pharyngitis, 335 — Inflammation of the Tonsils 
or Tonsilitis, 336 — Quinsy or Peritonsilar Abscess, 338 — Hoarseness or 
Laryngitis, 338 — Enlargement or Swelling of the Uvula, 339 — Dropsical 
Inflammation of the Larynx or Oedematous Laryngitis, 340. 

Diseases of the Lungs, 340 — Cold in the Chest or Acute Catarrhal Bronchitis, 
340 — Chronic Bronchitis, 342 — Pleurisy or Pleuritis, 343 — Dropsy of the 
Pleura or Hydrothorax, 344 — Asthma, 345 — Hay Asthma or Hay Fever or 
The Rose, 347 — Bleeding from the Lungs or Hemoptysis, 348 — Lobar Pneu- 
monia or Lung Fever or Winter Fever, 349 — Consumption, 351. 

Diseases of the Heart, 355 — Dilatation of the Heart, 355 — Inflammation of the 
Pericardium or Pericarditis, 355 — Palpitation of the Heart, 357 — Irregular 
Pulse or Arhythmia, 357 — Rapid Heart or Tachycardia, 358 — Slow Heart 
or Brachycardia, 359 — Neuralgia of the Heart or Angina Pectoris, 359 — 
Enlargement of the Ventricles of the Heart, 360 — Shrinking or Atrophy of 
the Heart, 361 — Fainting or Syncope, 361. 

Diseases of the Stomach, 362 — Inflammation of the Stomach or Acute Gas- 
tritis, 362 — Milk Sickness, 363 — Water Brash, 363 — Nausea and Vomiting, 
36-1 — Cramp or Spasm of the Stomach or Gastralgia, 365 — Dyspepsia or 
Indigestion, 365 — Gastric Ulcer or Ulcer of the Stomach, 368 — Gastric Can- 
cer or Cancer of the Stomach, 369. 

Diseases of the Bowels, 370 — Constipation, 370 — Intestinal Indigestion, 371 — 
Diarrhoea, 372 — Dysentery, 375 — Cholera Morbus, 376 — Colic, 378 — Painter's 
Colic, 378 — Wind Colic, 379 — Bilious Colic, 379 — Piles or Hemorrhoids, 
381 — Falling of the Bowel, 382 — Inflammation of the Peritoneum or Peri- 
tonitis, 382 — Fistula, 383 — Obstruction of the Bowel, 383 — Appendicitis or 
Inflammation of the Appendix, 384. 

Diseases of the Liver and Spleen, 385 — Jaundice or Icterus, 385 — Gallstones, 
386 — Congestion of the Liver, 387 — Gin-Drinker's Liver, 388 — Cancer of 
the Liver, 388 — Inflammation of the Spleen, 389. 

Diseases of the Kidneys, 389 — Diabetes Insipidus or Excessive Flow of Urine, 
389 — Diabetes Mellitus or Sugar Diabetes, 390 — Congestion of the Kidneys 
or Renal Congestion, 391 — Acute Bright's Disease, 391 — Chronic Bright's 
Disease, 392 — Uraemia, 393 — Suppression of L'rine, 394 — Incontinency of 
Urine, 395 — Gravel or Renal Calculi, 396 — Inflammation of the Bladder or 
Cystitis, 398. 

Infectious Diseases of Adults 400 

Dengue or Breakbone Fever, 400 — Erysipelas, 401 — Hydrophobia or Rabies. 
402 — Influenza or La Grippe, 404 — Lockjaw or Tetanus, 405 — Malaria or 



TABLE OF CONTENTS. 19 

Intermittent or Remittent Fever, 406 — Glanders or Farcy, 408 — Smallpox or 
Variola, 408 — Typhoid or Enteric Fever, 410 — Typhus Fever, 413 — Asiatic 
Cholera, 415. 

General Diseases of Adults 417 

Aneurism, 417 — Apoplexy, Cerebral Hemorrhage, Embolism or Thrombosis, 
417 — Epilepsy, 420 — Concussion or Inflammation of the Brain, 423 — Inflam- 
mation of the Outer Covering of the Brain or Pachymeningitis, 42-1 — 
Acute Meningitis, Cerebral or Brain Fever, 425 — Nervous Prostration 
or Neurasthenia, 426 — Locomotor Ataxia, 427 — Palsy or Paralysis, 428 — 
Anchylosis, 432 — Rheumatic Fever or Acute Articular Rheumatism, 432 — 
Muscular Rheumatism, 435 — Neuralgia, 436 — Anaemia, 439 — Cerebral Anae- 
mia, 440 — Congestion of the Brain, 441 — Dizziness or Vertigo, 443 — Abscess, 
444 — Abscess in the Ear, 445 — Ulcers, 445 — Corns, 446 — Ingrowing Nails, 
447— Chilblains, 448 — Rashes, 450— Rose Rash, 450— Hives or Nettle Rash, 
450 — Disorders of the Sweat Glands, 452 — Disorders of the Oil Glands, 
452 — Prickly Heat or Lichen, 453 — Irritation, Itching or Prurigo, 453 — 
Eczema, Herpes or Tetter, 455 — Moist Eczema, 455 — Milk Crust Eczema, 
456 — Ringworms, 456 — Carbuncle or Anthrax Benigna, 457 — Boil or Furun- 
culus, 458 — Excessive Perspiration or Hyperidrosis, 459 — Lice, 460. 



BOOK V. 
WOMANHOOD AND MOTHERHOOD. 

Menstruation, 461 — Delayed or Obstructed Menstruation or Amenorrhcea, 463— 
Suppressed Menstruation or Amenorrhcea, 46-1 — Painful Menstruation or 
Dysmenorrhcea, 466 — Profuse Menstruation, 466 — Falling of the Womb, 
468 — Cancer of the Womb, 468 — Inflammation of the Ovaries or Ovaritis, 
470 — Inflammation of the Womb, 470 — Whites or Leucorrhcea, 470 — Pruritis 
Vulvae, 471. 

Motherhood 472 

Pregnancy, 472 — Obstetrical Table, 473 — Signs of Pregnancy, 47-1 — Conduct 
During Pregnancy, 475 — Diet During Pregnancy, 475 — Dress and Exercise, 
476 — Moral Influences, 476 — The Breasts, 476 — Care of the Teeth During 
Pregnancy, 477. 

Diseases of Pregnancy, 481 — Morning Sickness, 481 — Constipation, 481 — Heart- 
burn, 482 — Incontinence of Urine, 482 — Coughs and Shortness of Breath, 
482 — Pruritis Vulvae or Itching, 483 — Insomnia or Sleeplessness, 483 — 
Melancholy or Despondency, 483 — Varicose Veins, 484 — Hemorrhoids or 
Piles, 48-1 — False Pregnancy, 484 — Abortion or Miscarriage, 485 — Prema- 
ture Birth, 487 — Confinement or Parturition, 487 — Preparation of Bed and 
Patient, 488 — The Breast, 490— Inflammation of the Breast, 490— Sore 



20 TABLE OF CONTEXTS. 

Nipples, 491 — ^lilk Fever, 491— The Lochia, 492— Afterpains, 492— Con- 
stipation After Deliver}-, 492 — Retention of Urine, 493 — Diet after Labor, 
493 — Puerperal Mania or Nervousness, 493 — Childbed Fever or Septicaemia, 
494. 

BOOK VI. 
CARE, FEEDING, AND DISEASES OF CHILDREN. 

Care of the Newborn Child, 495— First Suckling of the Child, 496— The 
Meconium, 496 — Urine, 496. 

Diseases of Newborn Children 496 

Apparent Death or Asphyxia, 496 — Jaundice of Newborn Infants, 498 — 
Inflammation of the Breasts of Infants, 499 — Erysipelas of Newborn Infants, 
499 — Lockjaw of the Newborn or Tetanus, 500 — Sore Eyes or Ophthalmia 
of the Newborn, 500 — Inflammation of the Navel or Omphalitis, 501 — 
Rupture of the Navel or Umbilical Hernia, 502. 

Care of Prematurely Born or Delicate Children 503 

The Nursery, 50-1 — Sleep, 506 — Airing, 506 — Exercise, 507 — Clothing, 507 — 
Bathing, 508— Growth and Development, 508 — Weight, 508 — Height, 509— 
Table of Weight and Height of Children, 510 — Development of the Muscles, 
511 — Development of Sight. 511 — Development of Hearing, 511 — Develop- 
ment of Taste and Smell, 511 — Development of Speech, 511. 

Feeding of Children 511 

Breast Feeding, 511 — Mothers Who Should Not Nurse, 512 — The Wet Nurse, 
512 — Mixed Feeding, 512 — Care of the Breasts During Nursing, 513 — 
Training the Child to Nurse, 513 — Time for Feeding During the First Year, 
513 — Weaning, 51-1 — Sterilizing Milk, 515 — Pasteurization of Milk, 516 — 
Peptonizing Milk, 516 — Condensed Milk, 517 — Infant Foods, 517 — Cow's 
Milk, 518 — Modification of Cow's Milk, 518 — Why it is Necessary to Modify 
Milk, 519— How is Cow's Milk Modified? 520— Formulas for Modified Milk, 
522 — Formula for the Second Day, 522 — Formula for the Fourth Day, 
522 — Formula for the Tenth Day, 522 — Formula for the Fifth Week, 522 — 
Formula for the Seventh to Ninth Week, 523 — Formula for the Third or 
Fourth Month, 523 — Formula for the Fifth and Sixth Months, 523 — Formula 
for the Seventh, Eighth, and Ninth Months, 52-1 — Formula for the Tenth 
and Eleventh Months, 524. 

Diet for a Child of One Year, 525— Diet for a Child Fifteen Months Old, 
525— Diet for a Child Two Years Old. 526— Diet During the Third Year, 526. 

Diseases of Children Caused by Improper Feeding, 529 — Rickets, 529 — 
Simple Wasting or Marasmus, 530 — Scurvy or Scorbutus, 531. 

Diseases of the Digestive Organs 533 



TABLE OF CONTENTS. 21 

Malformation of the Mouth, 533 — Harelip, 533 — Cleft Palate, 533 — Tongue- 
tie, 533. 

Teeth and Teething, 534 — Thumb Sucking, 536 — Lancing the Gums, 538 — 
The Toothbrush, 540— Filling a Child's Teeth, 541— Catarrh of the Mouth 
or Catarrhal Stomatitis, 542 — Canker or Follicular or Aphthous Stomatitis, 
543 — Putrid Sore Mouth or Ulcerative Stomatitis, 544 — Soor, Muguet, 
Sprue, White Mouth, Thrush or Parasitic Stomatitis, 544 — Inflammation of 
the Tonsils or Tonsilitis, 545 — Quinsy or Peritonsilar Abscess, 547 — Vomit- 
ing, 548 — Colic, 549 — Cramp in the Stomach or Gastralgia, 550 — Acute 
Stomach Indigestion, 550 — Diarrhoea, 552 — Summer Complaint or Cholera 
Infantum, 553 — Croup, 555 — Worms, 557 — Spasm of the Glottis or Child 
Crowing, 558 — Snuffles or Cold in the Head, 558 — Convulsions, Fits, and 
Spasms, 559. 

Infectious Diseases of Children 559 

Cerebro-Spinal Fever or Cerebro-Spinal Meningitis, 559 — Whooping Cough 
or Pertussis, 560 — Mumps or Parotiditis, 562 — Scarlet Fever or Scarlatina, 
563 — Measles or Rubeola, 565 — German Measles or Rubella, 56(5 — Diphthe- 
ria or Putrid Sore Throat, 567 — Chicken Pox or Varicella, 570. 



BOOK VII. 

ACCIDENTS AND EMERGENCIES. 
POISONS AND THEIR ANTIDOTES. 

Accidents and Emergencies 571 

Carrying Injured Persons, 571 — Bandages and Bandaging, 572 — How to 
Bandage, 575 — Bandaging the Leg, 575 — Bandaging the Arm, 575 — Many- 
tailed Bandage, 576 — Cross Bandage, 576 — Bandage for a Sprained Ankle, 
576 — Bandage for a Sprained Wrist, 577 — Bandage for a Cut Finger, 577 — 
Bandage for the Eyes, 577 — Bandage for Fractured Ribs, 577 — The T 
Bandage, 577. 

Hemorrhage, 580 — Arterial Hemorrhage, 580 — Venous Hemorrhage, 580 — 
Capillary Hemorrhage, 580 — Primary Hemorrhage, 583 — Secondary Hem- 
orrhage, 583 — Punctured Wounds, 583 — Contused Wounds, 583 — Lacerated 
Wounds, 583 — Gunshot Wounds, 583 — Incised Wounds, 584 — Bleeding from 
the Nose, 585 — Bleeding from the Lungs, 585 — Bleeding from the Stomach, 
585 — Bleeding from the Bowels, 585 — Bleeding from the Teeth, 585 — Hem- 
orrhage through the Vagina, 586. 

Wounds : Railway and Machinery Accidents 586 

Crushed Fingers or Toes, 586 — Crushed Feet or Hands, 586 — Crushed Arms 
or Legs, 586 — Crushed Chest or Lower Part of Body, 586 — Parts Torn 
Off, 586 — Bruises or Contusions, 586 — Contused Wounds, 587 — Cuts or 
Incised Wounds, 587 — Torn or Lacerated Wounds, 587 — Punctured Wounds, 
587— Healing of Wounds, 589. 



22 TABLE OF CONTENTS. 

Fractures, 589 — Fracture of Leg, 590 — Fracture of Arm, 590— Fracture of 
Skull, 591 — Fracture of Jaw, 591 — Fracture of Spine, 591 — Fracture of 
Ribs, 591 — Fracture of Collar Bone, 591 — Fracture of Finger, 592 — Fracture 
of Kneecap, 592. 

Sprains, 592 — Sprained Wrist, 592 — Sprained Ankle, 592 — Dislocation of the 
Elbow, 593 — Dislocation of the Lower Jaw, 593 — Dislocation of the Shoul- 
der, 594 — Dislocation of the Fingers, 594 — Dislocation of the Thumb, 594. 

Domestic Emergencies 595 

Infantile Spasms, 595 — Colic, 595 — Diarrhoea, 596 — Dysentery, 596 — Croup, 
59(5 — Whooping Cough, 596 — Toothache, 596 — Earache, 596 — Neuralgia, 
596 — Vomiting, 596 — Cholera Morbus, 596 — Pneumonia, 596 — Fever, 59(5 — 
Asthma, 59(5 — Burns and Scalds, 597 — Clothes Catching Fire, 597 — Burns 
with Acids, 598 — Burns with Lye and Alkalies, 598 — Bites and Stings of 
Insects, 598 — Snake Bites, 599 — Hydrophobia, 601 — Scratches or Bites of 
Cat, Bite of Rat, 601— Sunstroke, 601— Lightning Stroke, 602— Frostbite, 
602— Vertigo, 603— Injuries of the Head, 604. 

Apparent Death from Drowning, Strangulation or Suffocation, 606 — 

Artificial Respiration, 607— Sylvester's Method, 607— Method When the Arm 
is Broken or Injured, 609. 

Poisons and Their Antidotes 611 

Irritant Poisons, 611 — Narcotic Poisons, 611 — Emetics to be Used in Cases 
of Poisoning, 612 — Heart Stimulants, 612 — Respiratory Stimulants, 612 — 
Emollients and Demulcents, 612. 

Poisonous Plants of Wood, Field, and Garden 618 

Common Causes of Poisoning by Plants, 619 — Protective Measures, 620 — 
Fly Amanita, 620 — Death Cup, 621 — American False Hellebore, 622 — Lady's 
Slippers, 623 — Aconite, 624 — Larkspurs, 624 — Black Cherry, 625 — Kentucky 
Coffee Tree, 626— Woolly Loco Weed, 626— Rattlebox, 628— Spurges, 628— 
Poison Ivy, 631 — Poison Oak, 631 — Poison Sumac, 631 — Lily of the Valley, 
632 — Corn Cockle, 633 — Red Buckeye, 635 — Water Hemlock, 636 — Poison 
Hemlock, 637 — Broad-leaf Laurel, 638 — False Jessamine, 639 — Jimson Weed, 
640 — Black Nightshade, 641 — Bittersweet, 642 — Spreading Nightshade, 643 — 
Sneezeweed, 643 — Bloodroot, 644 — Indian Tobacco, 645. 



BOOK VIII. 
INJURIOUS HABITS AND THEIR EFFECTS. 

Alcoholism 646 

Proprietary Medicines, 646 — The First Steps, 646 — Who Pays the Drink 
Bill? 647 — To the Third and Fourth Generations, 647 — Marry a Drinking 
Man? 648— The Nursery of Crime, 648— Heroic Efforts, 648— The Good 
Old Times, 648— The Dangers of Alcoholism To-day, 648— The Three- 



TABLE OF CONTENTS. 23 

Headed Monster, 649 — Remedies, 649 — Alcoholism and Its Treatment, 650 — 
Causes, 650 — Effects of Alcohol, 650 — Symptoms of Acute Alcoholism, 651 — 
Delirium Tremens, 652 — Cigarettes, 656 — "Coffin Nails," 656 — Secret of Its 
Power, 656 — No Cigarette Fiend Need Apply, 657 — Birds of a Feather, 
658 — Popular Fallacies, 658 — The Real Reason, 658 — Tobacco Smoke, 658 — 
Guard the Children, 659. 

Drug Frauds 659 

Free Samples, 660 — Soothing Syrup, 661 — Cocaine Frauds, 661 — Morphine 
and the Drug Habit and Its Treatment, 662. 

Insanity 663 

Modern Scientific View, 663 — Emotional Insanity, 664 — Duty of Every One, 
664 — Who is Insane? 665 — Kinds of Insanity, 665 — The Test Question, 
666 — Causes, 666 — The Rush for Wealth, 666 — Rural Insanity, 667 — Solu- 
tion of a Great Problem, 668 — Treatment of the Insane, 668 — Safeguards 
of the Insane, 668 — Safeguards of the Sane, 669 — Responsibility of Experts, 
669 — Judge and Jury, 670. 

Suicide 670 

Causes, 670— Never Justifiable, 671— Moral, 671— Best Cure, 672— The 
Ancients, 672 — Punishment, 673 — Statistics of Suicide, 673. 



BOOK IX. 
SPECIAL SYSTEMS OF TREATING DISEASE. 

Homeopathy, 674 — Homeopathy in the United States, 674 — Provings, 675 — 
Homeopathic Statistics, 675 — Homeopathic Treatment of Disease, 676. 

Osteopathy 687 

How Malpositions Cause Disease, 687 — Other Lesions than Bony Ones, 
688 — Practical Therapeutics of Osteopathy, 689 — A Proper Examination, 
689 — How to Remove Conditions Found, 690 — General Manipulative Meas- 
ures, 691 — The Nerves of the Body, 691 — The Blood Supply, 692 — Specific 
Manipulation, 692 — Corrective Treatment, 692 — Diseases of Women, 693 — 
Fevers, 694. 

Radiotherapy 695 

X-Rays in Medicine and Surgery, 695 — Risk to Patients in X-Ray Exami- 
nation, 695 — The Fluoroscope, 696 — Foreign Bodies in the (Esophagus, 697 — 
Foreign Bodies in the Eyeball, 700 — Examination of the Brain, 700 — X-Rays 
in Dentistry, 700 — Detection of Incipient Consumption, 701 — Detection of 
Aneurism, 701 — Detection of Stone in the Kidney, Renal Calculi, 701 — 
Stone in the Bladder, 701 — Examination of Fractures, 701 — Location of 
Foreign Bodies, 702 — Measurement and Examination of the Pelvis, 703 — 
Curvature of the Spine, 703. 



24 TABLE OF CONTENTS. 

Orthopaedic Surgery 1 703 

Antitoxin in Diphtheria and the Use of Other Serum 703 

Vaccination, 705 — Mode of Vaccination, 705. 

Hydrotherapy 706 

Electrotherapy 709 

Multiple Neuritis, 709 — Facial Paralysis, 709 — Paralysis Agitans or Shaking 
Palsy, 710 — Hysteria, 710 — Neurasthenia or Nervous Prostration, 710 — Loco- 
motor Ataxia, 710 — Infantile Spinal Paralysis, 710 — Neuritis, 710. 

Phototherapy 710 

Hypnotism in Surgery 712 

BOOK X. 
ANATOMY AND PHYSIOLOGY. 

Anatomy and Physiology 715 

BOOK XI. 
MATERIA MEDICA. 

Materia Medica 775 

Description of all drugs recognized by the United States Pharmacopoeia, 
latest revision. Therapeutical and physiological effects, doses, and prepara- 
tions of official drugs. 

BOOK XII. 
USEFUL MEDICAL KNOWLEDGE. 

Family Medicine Chest 827 

Medical Dictionary » 829 

Useful Hints and Information ; 836 

INDEXES. 

Topical Index 841 

Emergency Index for Consulting in Accidents and Emergencies 871 



BOOK I. 

THE MAINTENANCE OF HEALTH 



PERSONAL HYGIENE. 

We are prodigal and wasteful of good health, and what we learn 
about the care of our bodies is often the result of bitter experience. There 
is a true saying that "We do not know the value of health until we have 
lost it." If it were possible for us to live our lives over, the greatest 
change and improvement that we would make would probably be in the 
direction of leading correct and hygienic lives. 

The word "hygiene" has a vague and somewhat meaningless force to 
the minds of many, who at best regard it as having something to do with 
medicine. We have only to remember that the word is derived from a 
Greek adjective meaning healthy. So highly was this branch of knowl- 
edge esteemed by the Greeks that they made Hygeia, the daughter of 
Esculapius, the goddess of health ; and the highest ideal of Greek citizen- 
ship was the possession of "a sound mind in a sound body." 

But probably the only successful attempt to connect the laws of health 
with the people's mode of life was that made by Moses in his wonderful 
association of hygiene and religion. In his system he minutely set down 
the laws of personal and tribal life to be carefully followed by his people. 
These laws impress us as being most intelligently adapted to the mode 
of living and the social conditions of his day. 

But the modern world has approached the question from another side, 
and instead of making the sanitary conditions depend almost wholly 
upon the efforts of the individual, there have been incorporated systems 
of sewerage, drainage, and water supply that secure results with less 
and less individual effort and responsibility. 

Health is that condition of mind and body in which all of the func- 
tions of the organs and parts are performed without pain or disease. Dis- 
ease may be regarded as the result of accident or of willful violation of 
Nature's laws. Nature knows absolutely no forgiveness. She is the most 
exacting, relentless, and impartial judge that ever presided over a court 
and inflicted punishment. Ignorance of the law is no excuse ; and there is 
no delay in the execution of sentence. We are not always conscious of 
the punishment and may at times congratulate ourselves that we have 



26 THE MAINTENANCE OF HEALTH. 

escaped the penalty of our hygienic transgressions. But when the day 
of reckoning comes, as it inevitably does, the folly of this attitude is 
very manifest. 

We must regard the observance of laws of right living as being of 
prime importance to those who are in good health. It is the means of 
maintaining good health. Hygiene is not a hobby or a fad. The prin- 
ciples are very simple and should form a large and early part of every 
child's education. Good health is the greatest heritage with which a 
person can be endowed. The first responsibility of parents is the enforce- 
ment of the laws of health, not only by precept but by example. Right 
living may easily be made a habit, so that any unhealthy conditions soon 
become a positive discomfort against which one turns instinctively. 

HYGIENE AND GENERAL CARE OF THE DIGESTIVE 

APPARATUS. 

The chief organs included in this group are the mouth, teeth, throat, 
stomach, and bowels. They need protection against cold and chills, for 
the diseases which attack them from this cause are very severe and 
dangerous. This is provided by suitable clothing, which is discussed 
in another section. The care of the skin has also a very important 
bearing upon these organs, and that has been taken up under the head 
of baths and bathing. Both of these points are very essential to the 
healthy condition of these organs. 

But the most important features in the hygiene of the very complex 
digestive system are food and exercise. 

Food. — An exhaustive consideration of the influence of food upon 
digestion calls for a discussion of the chemical nature of the several 
articles upon which man lives; the relative values of these articles as 
nourishment to the body; the digestibility of all the kinds of food; and 
the art of cooking. Obviously such a critical and exhaustive treatment 
of the subject is impossible at this time. But there are many generaliza- 
tions deduced from the array of facts gleaned by scientists which are of 
prime importance to assist us in the care of these important parts of 
our bodies. 

The evils which arise from disregard of the hygienic principles of 
food and digestion are largely due to the fact that the process of diges- 
tion, compared with other processes such as respiration and circulation, 
is tremendously complex. All complicated machines and systems are 



RAPID EATING. 27 

very easily put out of order with very serious consequences. Derange- 
ment of the digestive organs with the attendant train of evils is largely 
the result of a long period of slight but continued habits of abuse; and, 
as they are usually a long time in developing, they are a correspondingly 
long time in being removed, either by the correction of bad habits or by 
medical prescription. 

Selection of Food. — Except in the case of children, who are too 
young to make a wise selection of food, little attempt is made to prescribe 
a diet for healthy persons, who usually follow the dictates of the palate 
or the teachings of experience. Beyond certain broad principles, no 
hard and fast rules are possible for personal guidance in the choice of 
food ; for it has been wisely said that "what is one man's food is another 
man's poison." One soon learns what foods do not agree with one, and 
so knows what food to avoid. This is purely a matter of personal expe- 
rience. But old persons are often heard to say regretfully that as soon 
as one has learned from his own experience how to live right, it is time 
to die. 

Rapid Eating. — One of the greatest indiscretions is rapid eating, — 
a fault for which Americans, as a nation, are notorious. The evils inci- 
dent to this injurious habit are numerous and far-reaching. Not suffi- 
cient saliva is mixed with the food to digest it. The food is not chewed 
small enough to allow the digestive fluids to act upon it. The food, 
instead of being well chewed and mixed with saliva so that it may be 
easily swallowed, is forced down the throat in bulk by drinks which 
dilute and weaken the gastric juice. The food is forced into the stomach 
so rapidly and in such quantities that the stomach is overloaded before 
one knows it. The full taste of the food is not received by the palate, and 
hot sauces and condiments are used in too large and irritating quantities. 
So important and beneficial is the habit of slow eating that Fletcherism, 
so called from the sufferer from dyspepsia who discovered his own 
method of cure, advocates the chewing of all solids until they assume 
the consistency of cream, and that every substance, both solid and liquid, 
except water, be thoroughly chewed, — even tea and coffee passed back- 
wards and forwards in the mouth until intimately mixed with saliva 
before swallowing. This practice surpasses even Gladstone's famous 
advice to bite every mouthful of meat thirty times before swallowing. 

Irregular Meals. — Allowing too long a time to elapse between meals 
keeps the stomach idle for a period during which it secretes an oversupply 
of mucus which interferes with its efficiency. This applies to the habit 



28 THE MAINTENANCE OF HEALTH. 

of eating a very light breakfast or of doing without lunch, and, as a 
consequence, the indulgence of an abnormal appetite and the overloading 
of the stomach at the next meal. The work of the stomach must be 
equalized so that its powers may not be overtaxed at any time. It is 
equally injurious to follow one meal too quickly by another, which has 
the same effect as the pernicious habit of eating between meals. When 
food is taken into the stomach, the blood flows freely to that part where 
work is to be done. If a person has been engaged in mental work, study 
or business, the blood has been most abundant in the brain, which was 
the part most actively engaged. It is therefore well to allow a little 
interval to elapse between work and a meal, during which time the circu- 
lation of the blood may become equalized ; and for the same reason to let 
at least half an hour intervene between a meal and the resumption of work. 

The habit of eating heartily just before retiring is undoubtedly 
injurious. For sleep is a period of rest intended to refresh the whole 
body, not merely for the limbs and brain. The stomach is as much 
entitled to its period of rest as are the other members of the body. Slight 
wonder that it rebels when much is demanded of it while the other mem- 
bers are resting. Still, one must not risk going to bed hungry, for that 
state brings wakefulness and unrest. Light food, sufficient to appease 
the hunger, should be taken, but not a heavy meal of such food as is 
hard to digest. 

Moderation. — There is no doubt that as a rule we eat too much. 
The habits of overeating, especially at Thanksgiving and Christmas, have 
much to do with stomach derangements. It is not alone in the quantity 
of food that excesses are committed, but in the quality as well. Rich 
meats and gravies, highly flavored with piquant sauces to tempt jaded 
appetites; rich pastries, cakes, wines, and puddings; cold drinks, ices, 
dishes frappe and glace to stop the flow of gastric juice at a time it is 
most needed ; all of these imperfectly masticated and washed down with 
quantities of liquid to dilute the digestive fluids must inevitably cause 
the offender to suffer the penalty which inexorable Nature exacts — dys- 
pepsia, biliousness, gastritis, malnutrition, constipation, diarrhoea, obesity, 
and gout. 

Overeating. — If larger quantities of food are forced upon the 
stomach than it is capable of caring for, the first point to be noted is 
that the organs of digestion cannot cause the absorption of it all into 
the blood. Some of it must remain unacted upon. There is an impor- 
tant guard or watchman located at the lower end of the stomach, at 



CLASSIFICATION OF FOOD. 29 

the opening into the bowel, whose duty it is to see that no food passes 
that point until it has been acted upon by the juices in the stomach and 
has been thoroughly subjected to all of those processes of digestion which 
it is the duty of the stomach to perform well. This organ of watchful- 
ness is called the pylorus, from a Greek word meaning a gate. So long 
as the stomach is not overtaxed this guardian's work is well done. But 
when more food is taken into the stomach than can be properly cared 
for by it, or if food that is too difficult of digestion be presented to it, 
the pylorus seems to realize the futility of its objections, and offers but 
feeble resistance to the passage of a part of the undigested food into the 
bowel. The condition of affairs, then, is that a part of the undigested 
food remains in the stomach and a part of it passes into the intestine 
along with such food as has been digested. That which remains in the 
stomach putrefies and ferments. The results from this are disordered 
stomach, acidity of the stomach, fetid breath, sore throat, flatulency or 
wind on the stomach, wind "around the heart," a sense of fullness, and 
all the ills of dyspepsia quickly develop. That portion of the undigested 
food which passes into the intestine cannot be absorbed into the blood, 
and it, too, putrefies and ferments. From that follows wind in the intes- 
tines, accumulation of gases, pain in the bowels, torpor and heaviness, 
constipation, piles, absorption of faecal matter, and consequent blood- 
poisoning. And this condition is repeated from time to time by some 
persons almost daily, for the mere gratification of the palate at the 
expense of health, — perhaps of life itself. 

Deficiency of Food. — This term, in its usual significance, denotes 
that not enough nourishing food is taken into the system. This may 
be caused by a perverted appetite, which selects the wrong sorts of food, 
as is very often the case with children; or, even when no perversion of 
appetite exists, proper care is not taken that a right proportion of a 
particular sort of food demanded by the body is supplied. There may 
also be such an impaired condition of the organs of digestion that, even 
when good food is supplied, it cannot be properly acted upon so as tc 
afford nutrition. This is a form of dyspepsia which brings about 
malnutrition. 

Classification of Food. — In order to build up the several organs 
and to keep every part of the body in the best possible condition, four 
kinds or classes of foods are needed : — 

I. Nitrogenous Food. — Such foods, as the name signifies, are very 
rich in the gas called nitrogen. This is so important a constituent of 



3 o THE MAINTENANCE OF HEALTH. 

food that only such matter as contains it can produce flesh or repair 
wasted tissue, and it is, consequently, the basis of all flesh-forming foods. 
Nitrogenous foods also go by the name of albuminous foods, as the type 
of the class is the white of an egg, which is nearly pure albumen. They 
are also called proteids. Other common forms of this class are casein, 
the chief constituent of cheese; lean meat; and gluten, which gives the 
tough consistence to dough. 

2. Fats. — The fats are, chiefly, of animal origin, and are repre- 
sented by fat meat, butter, lard, and the several kinds of oils. Their chief 
use in the nourishment of the body is the storing up of food in the form 
of fat; and in maintaining the heat of the body. For the latter reason 
they are regarded as heat-producing foods. 

j. Carbonaceous Foods. — This group contains the starches and 
sugars. They are mainly of vegetable origin, and consist of cereals, 
peas, beans, potatoes, beets, fruits, sugar cane, etc. This class is a heat- 
producing group of foods, but they also aid in assimilation and in the 
production of fat. They contain from 40 to 45 per cent of carbon. 

4. Mineral Matter. — This group includes water, which is chemically 
regarded as a mineral, lime, phosphoric acid, potash, soda, chlorine, 
sulphur, iron, etc. Nearly three pints of water are needed daily by an 
adult to dissolve the food, to carry it through the circulation, to dissolve 
out waste matter, to moisten the tissues, and in evaporation from the 
body. The body of an adult weighing one hundred and fifty pounds 
contains over one hundred pounds of water, or about twelve gallons. 
The iron in such food enriches the blood and forms a constituent of the 
red blood corpuscles. Lime, phosphoric acid, and carbonic acid con- 
tribute to the strength of the teeth and the bones. Absence of these food 
elements in a child's diet brings about the enfeebled condition known 
as rickets. Salt is found in the liquids and secretions of the body, such 
as the tears, perspiration, etc. 

General Principles of Diet. — For the proper support of the body, 
the choice of food or the selection of menus must be based upon these 
broad principles : — 

1. There must be a proteid constituent — a food containing nitro- 
gen, — because nitrogenous or albuminous foods are needed to build up 
the essential framework of the body, which is every instant being worn out. 

2. There must be salts and mineral matter, for these are present in 
all of the tissues and fluids of the body. 

3. There must be either a fat or some article of carbonaceous food. 



A WELL BALANCED DIET. 31 

Although fat may be obtained from the proteids, such is not the usual 
source, nor could the requisite amount of fat be derived from the quan- 
tity of proteids consumed at a meal. As to the choice between fats and 
carbonaceous foods, it may be said that the carbonaceous foods are more 
easily digested than are the fats, but that the fats contain much more 
energy and force in a given quantity than do the carbonaceous foods. 

These laws are pretty generally observed unconsciously in every 
meal, for we eat bread and butter, a combination of a starch and a fat; 
rice and milk ; cheese and macaroni ; and pork and beans. 

Milk an Ideal Food for Children. — An appreciation of the needs of 
the body in these directions and a glance at the chemical composition of 
milk will at once make clear why it has come to be so highly esteemed 
as an article of food for children, and also why it is in itself a sufficiently 
nutritious diet during the early years. 

Milk is composed of : — 

Water, 87.00 per cent. 

Albumen, etc., 4.00 per cent. 

Sugar, 4.25 per cent. 

Fat, 4.00 per cent. 

Salts, 75 per cent. 

100.00 per cent. 

It is a nitrogenous food, since it contains albumen; the starch and 
sugar make it a carbonaceous food; fat is present as cream; and also a 
percentage of mineral matter as salts. It would serve admirably as an 
adult food were it not for the large percentage of water which it con- 
tains. This would necessitate the taking of larger quantities than the 
stomach can accommodate, and so the adult takes his nourishment in 
more concentrated form. 

The analysis of the composition of milk as given also serves to show 
that more than one of the four classes of food elements are to be found 
in a single article of diet. Food products may be at the same time both 
nitrogenous and carbonaceous ; or both fatty and rich in mineral matter. 

Need of Well Balanced Diet. — The necessity of the correct bal- 
ancing of diet according to the principles stated above cannot be too 
strongly impressed. A violation of the laws of diet is attended not only 
with imperfect nutrition and a loss of bodily energy and sustenance, but 
it provokes a number of ills and diseases. If too much nitrogenous food, 
such as lean meat, eggs, cheese, gluten, etc., be taken, the liver and kid- 
neys are overworked in their efforts to throw off the excess, and gout, 



32 THE MAINTENANCE OF HEALTH. 

rheumatism, and other kidney and liver troubles result. Much proteid 
matter and too little starch and sugar cause a loss of flesh and weight 
because the supply of fat-forming food is deficient. If too much starch 
and sugar are taken, there result dyspepsia, flatulence, acidity of the 
stomach, corpulence, and obesity. 

Value of Foods. — There is a very great difference in the nutritive 
qualities of the several articles of food usually consumed. The low 
degree of nutrition represented, by the table given below, as being sup- 
plied by milk, which has just been spoken of as an ideal food, and of 
turnips, and some others, is due to the relatively large amount of water 
which they contain. This of course reduces the value of a pound of 
milk when compared with a pound of olive oil, or of wheat bread. In 
the list here given, the common food articles are arranged in the order 
of their relative nutritive properties, beginning with the most nutritious. 
A perfect food, if such existed, would be marked ioo: — 

TABLE OF FOOD VALUES. 

Olive oil, 96 Blood, 22 

Wheat bread, baked, 95 Sole, fried, 21 

Peas, dry, boiled, 93 Pork, roast, 21 

Barley, boiled 92 Flour, bolted, in bread, 21 

Rice, boiled, 88 Codfish, boiled, 21 

Beans, dry, boiled, 87 Peaches, raw, 20 

Bread, baked, 80 Soup, barley, boiled, 20 

Rye flour, baked, 79 Gooseberries, raw, 19 

Oatmeal, 74 Haddock, boiled, 18 

Almonds, raw, 66 Potatoes, boiled, 13 

Flour, unbolted in bread, 35 Eggs, whipped, 13 

Mutton, roast, 30 Strawberries, raw, 12 

Plums, raw, 29 Apples, raw 10 

Chickens, fricasseed, 27 Carrots, boiled, 10 

Grapes, raw, 27 Pears, raw, 10 

Apricots, raw, 26 Cabbage, boiled, 7 

Beef, roast 26 Milk, 7 

Cherries, raw, 25 Turnips, boiled, 4 

Veal, fried, 25 Melons, raw, 3 

Venison, broiled, 22 Cucumbers, raw, 2 

Digestibility of Food. — The following table of the digestibility of 
the several articles commonly used as food, beginning with the easiest, 
is based upon the judgment and experience of the most eminent authori- 
ties. It will prove helpful in arranging a diet in sickness and in health : — - 



DIGESTIBILITY OF FOOD. 33 



TABLE OF DIGESTIBILITY OF FOOD. 

Food. Time Required for Digestion. 

Rice, boiled, 1 hour 

Pig's feet, soused, boiled, 1 hour 

Tripe, soused, boiled, 1 hour 

Eggs, whipped, raw, 1 hour 30 minutes 

Trout, salmon, fresh, boiled or fried, 1 hour 30 minutes 

Soup, barley, boiled, 1 hour 30 minutes 

Apples, sweet, raw, 1 hour 30 minutes 

Venison steak, broiled, 1 hour 35 minutes 

Sago, boiled, 1 hour 45 minutes 

Tapioca, boiled, 2 hours 

Barley, boiled, 2 hours 

Milk, boiled, 2 hours 

Liver, beef's, broiled, 2 hours 

Eggs, fresh, raw, 2 hours 

Codfish, cured, boiled, 2 hours 

Apples, sour, raw, 2 hours 

Cabbage, with vinegar, raw, 2 hours 

Milk, raw, 2 hours 15 minutes 

Turkey, wild, roasted, 2 hours 20 minutes 

Turkey, domestic, boiled, 2 hours 25 minutes 

Gelatine, boiled, 2 hours 25 minutes 

Turkey, domestic, roasted, 2 hours 30 minutes 

Goose, wild, roasted, 2 hours 30 minutes 

Fig, sucking, roasted, 2 hours 30 minutes 

Hash, meat and vegetables, warmed, 2 hours 30 minutes 

Beans, string, boiled, , . . . 2 hours 30 minutes 

Cake, sponge, baked, .2 hours 30 minutes 

Parsnips, boiled, 2 hours 30 minutes 

Potatoes, Irish, roasted, 2 hours 30 minutes 

Chicken, fricasseed, 2 hours 45 minutes 

Custard, baked, 2 hours 45 minutes 

Beef, plain boiled, 2 hours 45 minutes 

Apples, sour, hard, raw, 2 hours 50 minutes 

Oysters, fresh, raw, 2 hours 55 minutes 

Eggs, fresh, soft-boiled, 3 hours 

Bass, fresh, striped, broiled, 3 hours 

Beef, fresh, lean, rare, roast, 3 hours 

Pork, newly salted, stewed, 3 hours 

Mutton, fresh, broiled, 3 hours 

Soup, boiled, 3 hours 

Chicken soup, boiled, 3 hours 

Dumpling, apple, boiled, 3 hours 



34 THE MAINTENANCE OF HEALTH. 

TABLE OF DIGESTIBILITY OF FOOD— Continued. 

Food. Time Required for Digestion. 

Corn cake, baked, 3 hours 

Oysters, fresh, roasted, 3 hours 

Pork steak, broiled, 3 hours 1 5 minutes 

Mutton, fresh, roasted, 3 hours 1 5 minutes 

Corn bread, baked, 3 hours 1 5 minutes 

Carrot, boiled, . . . 3 hours 15 minutes 

Sausage, fresh, broiled, 3 hours 30 minutes 

Oysters, fresh, stewed, 3 hours 30 minutes 

Butter, 3 hours 30 minutes 

Cheese, old, strong, 3 hours 30 minutes 

Soup, mutton, boiled, 3 hours 30 minutes 

Oyster soup, boiled, 3 hours 30 minutes 

Wheat bread, fresh, baked, 3 hours 30 minutes 

Turnips, boiled, 3 hours 30 minutes 

Potatoes, Irish, boiled, 3 hours 30 minutes 

Eggs, fresh, hard-boiled, 3 hours 30 minutes 

Green corn and beans, boiled, 3 hours 45 minutes 

Beets, boiled, 3 hours 45 minutes 

Salmon, salted, boiled, 4 hours 

Beef, fried, 4 hours 

Veal, fresh, broiled, 4 hours 

Arranging a Diet. — By reference to the foregoing tables of nutritive 
values and of the digestibility of foods, the selection of a suitable diet 
for special cases will be greatly facilitated. 

These tables should be read together in making a choice of food. For 
it is plain that a food may be highly nutritive and yet very difficult to 
digest. Such a condition is worse than a food of medium nutritive 
quality and of easy digestion. No table of the digestibility of food can 
be arranged which will be true for every individual. Personal peculiari- 
ties, idiosyncrasies, and more or less impairment of the digestive organs, 
all operate as factors which are hardly capable of being accurately 
estimated. One's own experience must be a modifying element in all 
selection. 

There are, however, other considerations, besides nutritive and diges- 
tible qualities of food, to influence a careful and competent selection. 

Diet Governed by Climate. — The influence of climate and the sea- 
sons, in deciding the sorts of food which should be chosen, is of prime 
importance. In cold climates and in the winter season there is great 
need of the heat-producing foods, the fats and the carbonaceous foods. 



SELECTION OF A DIET. 35 

Almost incredible quantities of oil, blubber, and fat meat are reported to 
be consumed in the diet of the Esquimaux and other arctic inhabitants. 
Dr. Hayes, the arctic explorer, says that the daily ration of the Esqui- 
maux with whom he came in contact was from twelve to fifteen pounds 
of meat, one-third of it fat, to each person. He saw one man eat ten 
pounds of walrus meat and blubber at a single meal. Such instances 
must not, however, be regarded as gluttony on the part of these people, 
but as the requirements of the body for fortification against the rigors 
of the climate. On the other hand the inhabitant of the tropics subsists 
almost wholly upon a diet of juicy, watery, cooling fruits. 

Our diet, then, in winter should be largely carbonaceous food, com- 
prising meats, fats, and oils, in abundance. In summer it should consist 
of a liberal allowance of fresh vegetables and fruits. Fortunately Nature 
contributes to make such an arrangement easy, as the summer season is 
one of abundance of the very foods most desirable at that time. 

Diet Governed by Age. — In youth, during the growing period, the 
repair or upbuilding of the tissues is greater than the waste; in middle 
life the repair and waste are about equal; and in old age the waste is 
greater than the repair. Therefore, it may be briefly concluded that the 
diet of young persons should be largely of a vegetable nature and of 
a more nourishing kind than the diet of old age. 

Diet Governed by Occupation. — Occupation is intended to repre- 
sent the amount of manual work performed or the amount of exercise 
taken; which must be provided for in the selection of a suitable diet. 
When great muscular exertion is required, nitrogenous foods are to pre- 
dominate in the diet, for they are the foods that rebuild the muscles that 
are worn down by use. In sedentary occupations carbonaceous foods 
are to abound. The appetite is a great regulator in such cases. If the 
wrong sort of food is presented, according to the needs of the body, or 
of a particular case, that food will be partaken of in large quantities in 
the effort to get a sufficient quantity of the required nourishment. This 
unsatisfied need of the body, in a measure, explains the possibility of a 
person eating heartily of food with apparent good appetite, and yet com- 
plaining of feeling hungry. This is an almost sure sign that a change 
of diet is needed. It will also be realized that the excessive amount 
taken in the effort to satisfy the natural craving of the appetite entails a 
lot of unnecessary work upon the digestive organs. 

Change of Conditions. — One should be always watchful to adjust 
the diet to a change of occupation or of climate. Where one has been 



36 THE MAINTENANCE OF HEALTH. 

leading an active life of manual labor or of much exercise, and then 
changes to a sedentary occupation, one must not expect to maintain the 
same dietary supply as formerly, but must endeavor to adapt the diet to 
one's new needs as quickly as possible. It may be that even with one's 
best efforts in this direction there will be a period of greater or less dis- 
turbance in the endeavor to meet the new requirements. 

Pure Food. — An important duty in connection with the supply of 
food is the exercise of that care in its selection which is necessary to 
procure articles of good quality and of insured purity. Government 
inspection of meats, and of food generally, does much in the way of 
regulating the sale and the supply of food. But even the best efforts 
of inspectors do not prevent goods of poor quality and even of impurity 
from being offered for sale. Ptomaine poisoning results from eating 
tainted meat or poultry. Tapeworm is transferred from the flesh of 
the pig and ox to the human body, and the well known disease of trichi- 
niasis is communicated to man from a parasite in pork. Parasites in 
meat, capable of communicating disease to man, are certainly destroyed 
by thorough cooking. At least it is the requisite degree of heat through- 
out the entire portion of the meat that kills the germs. But tainted meat, 
poultry, and fish are not rendered harmless by cooking; and oysters and 
other shellfish eaten raw have often been the means of communicating 
dangerous diseases. Milk is recognized as a means of spreading disease ; 
and, as a precaution, all milk is, or should be, pasteurized. In this 
process the milk is heated to 160 Fahrenheit, at which temperature the 
germs of disease which it may contain are killed. Many cases of fatal 
poisoning have resulted from the careless habit of opening canned goods, 
using a part of the contents, and leaving the remnant in the opened tin 
for future use. This is lead poisoning caused by the fruit acid acting 
on the solder of the tin in the presence of oxygen in the air. As soon as 
a can of goods is opened, the contents should be at once removed to 
another vessel, if it is not intended for immediate use or cooking. The 
same effects have resulted from eating ice cream which has become 
affected in a similar way. 

How to Detect Impure Food. — Adulteration of food is quite com- 
mon. The methods of detecting some of these cheap and harmful 
compounds are extremely simple and can be performed by anyone. It 
is a great satisfaction to know something of the purity of the articles of 
food which one is using. It is a well understood fact that when it is 
generally known that one has a pair of scales in the house, one is very 



TESTS OF THE PURITY OF FOOD. 37 

likely always to get full weight. So when one has even a slight reputa- 
tion as a domestic analyst, there is small likelihood that an inferior article 
of food will be offered. 

To examine a specimen of coffee, take the whole bean. Many believe 
that it is only the unground coffee that is free from adulteration, and 
that by having a mill at home they will insure a purer article. It may 
surprise such to know that the coffee bean is adulterated with artificial 
coffee beans or pellets which are made from wheat bran roasted and from 
chicory. To detect these, take a cup of water and put into it a few of 
the whole beans. The genuine coffee beans will float on the top of the 
water while the adulterants will sink to the bottom. Then take some of 
the ground coffee and try it in the same way in another cup of water. 
The grains of pure coffee will float and will not color the water for some 
minutes. The grains of chicory and cereals will sink to the bottom and 
will leave a colored trail behind them as they fall. 

There is another test for "ground coffee, which depends simply upon 
examination by the unaided eye. Spread some of the grains upon a 
piece of writing paper and examine them closely. Genuine coffee grains 
are of a dull color. They also have the coffee taste. Chicory grains are 
dark colored and have an appearance like that of gum. When tasted 
they are found to be very soft and bitter. Grains of cereal have a smooth 
and polished surface and are devoid of taste. 

Honey, jams, jellies, syrups, and similar preparations often depend 
for their sweet taste upon the presence of glucose. This is a very cheap 
substitute for sugar, and is made by treating cornstarch with an acid. 
To detect the presence of glucose in any preparation a very strong alcohol 
is required. Pour a small quantity of 95 per cent alcohol into a tumbler. 
Then take a spoonful of the substance to be tested and slowly pour it 
into the alcohol. If glucose is present the alcohol will show a milky 
color, and a thick substance like gum will settle on the bottom of the 
glass. The milky appearance of the alcohol will remain for a long time. 
But if no glucose is present a white flaky sediment will settle to the 
bottom of the glass, and in a few minutes the alcohol will be quite clear. 

Many jams, jellies, syrups, tomato ketchup, and the like, owe their 
brilliant color to the use of a dye, generally an aniline dye. The test in 
such cases is simply to learn whether or not- the suspected substance will 
dye a piece of woolen goods. Take a small quantity — two or three 
spoonfuls — of the suspected substance and stir it into rather less than a 
pint of water. Place this in a stewpan. Take a small piece of all-wool 



3 8 THE MAINTENANCE OF HEALTH. 

white goods such as nun's veiling, and pour boiling water over it until it 
is thoroughly saturated. Then place it in the solution and boil it for 
about ten minutes, stirring it meanwhile. If there is any dye present 
it will impart a bright, vivid color to the piece of goods. Natural juices 
from fruit are of a dull or dead color. If there is any doubt of the char- 
acter of the stain on the cloth, boil the dyed cloth with a tablespoonful 
of ordinary ammonia in a pint of water for five minutes. Then remove 
the cloth; add a few tablespoonfuls of vinegar to the ammonia; put in 
a new or clean piece of cloth, and boil again for five or ten 
minutes. If the new piece of cloth is colored there is aniline 
or other dye present. The explanation is that the color was extracted 
from the first piece of cloth by the ammonia, and when the vinegar was 
added and the clean piece of cloth boiled in the discolored ammonia, the 
dye was imparted to the cloth. If the coloring matter in the first piece 
of cloth were only the natural juice of the fruit, it would not have been 
removed from it by the ammonia. This experiment will prove the pres- 
ence of a dye in any article of food. 

The presence of coloring matter in milk may be detected by allowing 
the cream to rise and then comparing the color of the cream with that 
of the milk. In natural colored milk the cream is always more yellow 
than the milk from which it rises. If the milk is as yellow or more 
so than the cream, there is little doubt that a yellow coloring matter has 
been added to make up for some deficiency in the quality of the milk. 

To test the purity of butter, take a piece as large as the end of one's 
thumb. Place this in a spoon and heat it over the flame of an alcohol 
lamp or a candle. After it has melted, lower it into the flame so that it 
will boil. Stir it well during the boiling. If the sample is butter, the 
boiling will be attended with very little noise, and there will be a great 
deal of foam ; oleomargarine or artificial butter will boil very noisily and 
there will be very little foam. Another test is applied by taking a tin 
cupful of sweet milk and placing in it a small lump of the butter. Heat 
the milk and stir while the butter is melting. Then place the cup in 
broken ice so as to cause it to cool rapidly. Now observe the action of 
the sample while cooling. If it is butter the mass will form small grains 
as it does in the churn, and cannot be gathered together in a lump. Oleo- 
margarine or artificial butter will gather in a mass. 

To test vanilla flavoring extract, place some in a small bowl and set 
it in the top of the teakettle. Allow it to boil or evaporate until there 
is only one-third of the original volume. Then add water enough to 



TESTS OF PURE FOOD. 39 

make up the original quantity. If there is a red, flaky sediment in the 
bottom of the bowl it is vanilla of good quality. If there is no sediment, 
the article is artificial. 

To test the purity of lemon flavoring extract, take a tumblerful of 
water and add a teaspoonful of the lemon extract to it. If there is a 
cloudy appearance communicated to the water, the extract is artificial 
and there is no pure lemon oil present. If there is reason to suspect that 
the liquid is colored artificially, and not by the rind of lemon peel, the 
dyeing test given above may be used. 

To test for the presence of alum in baking powder, get a few chips 
of logwood and pour water upon them and boil. Pour off the liquid and 
add more water and boil again. Repeat this so as to get the fourth 
water. Add a teaspoonful or two of the baking powder to a half tumbler- 
ful of water. Then add two tablespoonfuls of vinegar and pour in two 
or three drops of the extract of logwood. If alum is present the solution 
will turn reddish blue. If there is no alum the solution will be yellow. 

The first quality which milk should possess is that of cleanliness, not 
only as a direct essential to health but in order that the milk will keep. 
Cleanliness is the best preservative, and, indeed, the only one that is really 
permissible outside of temperature. It is a difficult matter to detect an 
impure condition of milk resulting from this necessary lack of care. The 
senses of sight, smell, and taste are reliable guides so far as they go; 
but a sample of milk may easily pass these guards and yet be wholly unfit 
for use. The reputation of the dealer is about all that one can go on 
in that case. The commonest form of adulteration, if it can be regarded 
as adulteration, is the reducing of the strength of the milk by (1) the 
addition of water, (2) the addition of skim milk, or (3) the removal of 
cream. This dilution can easily be detected by the use of the lactometer, 
which is a simple, inexpensive instrument for ascertaining the density 
or specific gravity of milk. It will tell whether the cream has been 
removed. A simpler test is to pour some fresh milk into a glass and 
set it aside to allow the cream to rise. The amount of cream which 
forms is an indication of the strength of the milk. By using samples 
from several sources, one can easily select the richest. If milk spoils 
without souring, a preservative has been used. It is safe to say that 
all preservatives are injurious. The commonest in use are borax or 
boric acid, salicylic acid, and formaldehyde. These are all preventives 
of the growth of the germ which causes milk to sour, and are undesirable 
constituents of food, especially for young children. 



4 o THE MAINTENANCE OF HEALTH. 

The safest way to guard against injurious canned goods is to make it a 
rule to accept no cans which do not bear the name of the packer. The 
greatest danger arises from the too common custom of cleaning up old 
stock and putting on a new fresh wrapper in bright colors, attractively 
printed, but bearing no name of the person upon whom responsibility can 
be placed. A man who is ashamed to have his name appear upon his 
product is unworthy of patronage. 

Unripe Fruit. — Eating unripe fruit, a common practice with chil- 
dren, is often the direct cause of diseases of the digestive organs. Much 
disturbance of these organs is also caused by eating too heartily of new 
fruits and vegetables. When such first come in season the system is 
not prepared for them, and they should be used moderately and with 
caution. The dangers seem to be lessened considerably in these days of 
cold storage, which not only insures a riper grade of fruit than was 
possible formerly, but the season for all fruits and vegetables has been 
vastly extended by its use. 

Constitution and Temperament. — In all families the diet should 
be arranged so as to suit the constitution and temperament of each one 
of its members. If, as is too often the case, the menu is prescribed to 
suit the taste, occupation, and age of the father of the family, it is unrea- 
sonable to expect the anaemic girl or the nervous boy to be properly nour- 
ished or satisfied with it. When such is the case, the unreasonableness of it 
all is increased by a, perhaps, well-intentioned effort to force the children 
to partake of some of the dishes for which they have expressed a distaste. 
It is not merely a matter of kindness to prepare a special dish for one 
or more of the younger members of the family, but it really is imperative 
that such be done. No thoughtful mother will allow considerations of 
extra work and cooking to prevent this attention to the needs of her 
children. 

Those of a sanguine temperament require a moderate quantity of 
simple food. They should avoid the use of sauces and condiments, 
pepper, and highly seasoned food. Stimulating drinks are also to be 
excluded from their diet. 

Those of a lymphatic or phlegmatic temperament require an abun- 
dance of nourishing food, with a good supply of animal food, fresh vege- 
tables and fruits. 

Those of a bilious temperament are so subject to derangements of 
the digestive organs that the question of their diet is often perplexing. 
Easily digested, well cooked food of high nourishing quality is essential. 



CONCENTRATED FOODS. 41 

Those of a nervous temperament are also extremely difficult to pro- 
vide for. If the food is not rich enough, impure blood is sent to the 
brain, the seat of the nervous system, and nervous derangements will 
surely be aggravated. If the food is too stimulating, or if too substan- 
tial a diet be supplied, the blood becomes too much enriched, and therefore 
too stimulating and exciting, which is the very condition sought to be 
avoided in these cases. 

Good Cooking. — A great advance has been made in recent years in 
the art of cooking. There is now little truth in the assertion that much 
good food is spoiled by bad cooking. It is more nearly correct to say 
that inferior food is often improved by good cooking. Every year shows 
a decided advance in the science and art of preparing food. This is to 
be regarded as a great improvement in hygiene and health. It is possible, 
however, that great skill in the preparation of appetizing and savory 
dishes may be responsible for many cases of excesses in eating. 

Abstinence. — There are times when it would be vastly better to 
miss a meal than to eat one. When one approaches a meal hour without 
a desire for food, one should not let habit force one to partake of the 
food. Judicious abstinence on occasions is one of Nature's own means 
of self-defense. Highly seasoned dishes with savory sauces are often a 
spur to a jaded appetite caused by surfeit and over-indulgence. 

Concentrated Foods. — There are a great many concentrated foods 
on the market for which great claims are made by the manufacturers. 
It must be remembered that there is a limit to concentration, beyond 
which the value of the article as nourishing food is more than doubtful. 
The common statement that a lozenge of concentrated food contains as 
much nourishment as a beefsteak is not only untrue but absurd. Some 
go so far as to claim that a few lozenges contain all the nourishment 
which an adult will require for an entire day's sustenance. This claim 
is equally absurd and untrue. For the weight of chemically dry, water- 
free food which an adult requires in a day while in a state of perfect 
rest is 16 ounces; while engaged in ordinary work, 22^ ounces. 

When highly concentrated, predigested food is presented to the stom- 
ach in a state of health, that organ seems to resent the premature inter- 
ference with its duties, There results a loss of appetite and either 
diarrhcea or constipation. It is also clearly established that the digestive 
'juices require something undigested to work upon; and considerable bulk 
of food is also required for the proper distention of the stomach and 
bowels, in order that these organs may properly discharge their several 



42 THE MAINTENANCE OF HEALTH. 

functions. The fact that some of these concentrated foods may be not 
only highly beneficial but absolutely indispensable in some forms of 
disease is no proof that they are a fit food in a state of health. Their 
greatest recommendation is the fact that they are easily carried by those 
who are obliged to transport quantities of food in small space to remote 
parts of the world. 

Daily Ration in Health. — The distribution of the food elements, the 
quantity of food required by an adult in a state of health, and the variety 
of the food, may, perhaps, be best illustrated by the daily ration served 
to each soldier in the United States army. On comparison with the 
daily ration of soldiers of the armies of other countries, this is said to 
be the most generous allowance to any : — 

Bread or flour, 22 ounces. 

Fresh or salt beef, 20 ounces. 

Or pork or bacon, 12 ounces. 

Potatoes, three times a week, 16 ounces. 

Rice, 1.6 ounces. 

Coffee, 1.6 ounces. 

Or tea, 0.24 ounces. 

Sugar, 2.4 ounces. 

Beans, 0.64 gill. 

Vinegar, 0.32 gill. 

Salt, o. 16 gill. 



THE WATER WE DRINK AND ITS EFFECTS. 

Absolutely pure water has no color, taste, or odor, and is composed 
of two parts of hydrogen gas and sixteen parts of oxygen gas by weight. 
Natural water is classified as follows : Rain water, spring water, river 
water, lake water, and sea water. These, however, are never found 
chemically pure; only distilled water is such. The impurities found in 
water are either solid or gaseous; and are either suspended in it or are 
dissolved in it. 

Rain water is the purest of all natural waters. It always contains 
gases dissolved in it, especially nitrogen, oxygen, carbon dioxide, and 
ammonia gas. These are washed out of the atmosphere as the rain falls 
through the air. Ice water in the form of melted ice is purer than rain 
^ater, for, in the process of freezing, the solids and gases are expelled. 



IMPURITIES OF DRINKING WATER. 43 

Spring water is rain water which, in its passage through the earth, 
dissolves out of the soil, and unites chemically with certain substances 
which produce the mineral ingredients found in spring water. There 
are common springs which yield fresh water, mineral springs which 
supply mineral water, and thermal and medicinal springs. Well water, 
when obtained from a deep well, is much the same as spring water. But 
surface or shallow springs and wells yield, usually, polluted or contami- 
nated water by reason of the surface drainage into them and the imper- 
fect filtration, as the water does not pass through deep layers of soil in 
reaching them. If there is much mineral matter contained in water it 
is said to be "hard" ; if only a slight quantity, it is called "soft." Hard 
waters do not make a good lather with soap; and sea water none at all. 

River water partakes very largely of the nature of the soil over which 
it flows. There is always a large percentage of organic matter contained 
in river water, which is washed into it from the surface of the ground. 

Lake water varies greatly in mineral matter, and includes salt lakes, 
like that of Utah and the Dead Sea, and all the modifications of these 
down to the freshest and clearest of waters. As the water in a lake is 
not so much subject to agitation as it is when flowing in a river, much of 
the suspended organic matter of the river water subsides and falls as 
a sediment to the bottom of the lake, leaving the water clearer and less 
turbid. Lakes, therefore, are natural reservoirs and are among the best 
sources of a good water supply. 

Impurities of Drinking Water. — The gases and minerals dissolved 
in water are not all harmful or disagreeable. Indeed, many of them 
remove the insipid taste of distilled water. Besides the gases and dis- 
solved mineral matter we find certain solids suspended in the water or 
falling to the bottom as a sediment when at rest. These are minute 
particles of clay, sand, etc. ; vegetable and animal matter ; and living 
organisms. Micro-organisms, or bacteria, are found in large numbers 
in all water, except spring water, which has passed through a deep layer 
of fine soil, by which means the bacteria are filtered out. These micro- 
organisms vary in number from two in a cubic centimeter of water drawn 
from an artesian well to thirty-eight million in a cubic centimeter of 
sewer water. There are more bacteria in water during hot than during 
cold weather. These germs find their way into the water from both 
the air and the soil. Under favorable conditions they multiply very 
rapidly in water. The fact that micro-organisms are found in water does 
not mean anything, for they are found in all water; nor is it important 



44 THE MAINTENANCE OF HEALTH. 

that there are few or many; but it is of the utmost importance to ascer- 
tain whether or not they are the bacteria of any specific disease, and 
whether or not they are characteristic sewage or surface drainage germs. 
The determination of these points decides the purity or impurity of the 
water. 

The refuse from some mills and certain manufactures, when allowed 
to escape into rivers, are also frequent sources of pollution and contami- 
nation of water. 

The pipes by which water is conveyed sometimes yield such impuri- 
ties as lead, zinc, or iron; and wooden pipes, in the process of decay, 
impregnate it with dead organic matter. 

Leaking sewer and gas pipes, and the drainage from cesspools, are 
common causes of impurity of water. A curious instance is known 
where a sudden diminution of the water pressure in water pipes created 
a partial vacuum within the pipe and sewer air or water was sucked into 
the water pipes, resulting in an epidemic of typhoid fever. 

Effects of Impurities in Water. — Sewer gases, when dissolved in 
water, are known to produce diarrhoea, as does also hydrogen sulphide 
gas, a constituent of illuminating gas. Some of the "hard" waters pro- 
duce calculus, or stone in the bladder. Lime salts in water produce 
dyspepsia, as does iron, with the additional effect of. constipation. Dis- 
solved vegetable and organic matter produces fevers and diarrhoea. 
Turbid water, containing particles of clay, vegetable matter, and the like, 
causes diarrhoea, dysentery, and, sometimes, fevers and cholera. 

Tests for Drinking Water. — The chemical, microscopical, and 
bacteriological tests for drinking water are, of course, a matter for the 
trained specialist. But there are a few physical tests which anyone may 
easily apply. The points to be noted are : — 

I. Color. — The water under examination should be allowed to 
remain at rest for a time in order that any sediment may settle to the 
bottom of the vessel. The clear water above is then to be poured into 
a clean glass vessel, and a sheet of white paper is placed behind or below 
it. In this way the color is noted. To do this properly the glass vessel 
should have a diameter of at least eighteen inches. If a glass vessel 
containing distilled water be placed beside it for comparison a better 
result will be reached. A bluish tinge characterizes perfectly pure water ; 
a grayish tinge is not objectionable; a greenish tinge may result from 
harmless algae, or water plants; yellowish or brownish hues result from 
iron salts, peat, animal matter, or sewage. 



TO PURIFY WATER. 45 

2. Clearness or Turbidity. — The water should then be well shaken 
up so as to distribute the sediment, and a printed page should be placed 
behind or below the glass vessel so as to estimate the depth of water 
through which the page may be read. If the turbidity does not subside 
after the water has stood at rest for some time, it is caused by finely 
divided particles of clay. 

j. Sediment. — This may be classified approximately, as : absent, 
minute, slight, large, or very large. Some idea may also be given of its 
nature, as : sandy, clayey, reddish ; and the presence of any large particles 
of organic matter, as chips, minute fragments of leaves, grass, etc., may 
be noted. 

4. Luster. — If highly aerated, the water sparkles. Polluted river 
or well water, or stagnant water, has no luster. 

5. Taste.— A good tasting water may be impure ; but a bad tasting 
water should be unhesitatingly condemned. 

6. Smell. — Slightly heat the water and then observe the odor, or 
the absence of it. When water is heated, the gases are liberated and 
the odor is much more pronounced than when cold. A bad odor is 
another cause for the immediate rejection of a water. But the absence 
of odor is not in itself a proof of its purity. Generally speaking, a water 
that is colorless, clear, free from sediment, sparkling, and devoid of taste 
or odor may be regarded as safe to drink. 

To Purify Water. — The safest and most convenient methods of 
insuring good water in the home are filtration and boiling. The process 
of filtration most generally employed is that of some mechanical method 
where the filter employed contains either sand, porcelain, asbestos, 
or some form of carbon or charcoal. The great objection to the 
most effective methods of filtering is the slow delivery of the filtered 
water; and, while the water delivered may be clear and apparently fit 
for use, there is no assurance that the germs of disease which the water 
may have contained are removed. The great safeguard, then, is to boil 
the water. While this is an effective means of killing all disease germs 
in the water, it has the objectionable effect of driving off the gases dis- 
solved in the water and thereby rendering the water insipid and unpal- 
atable. In cases of suspected impurity of water, and during seasons of 
epidemic, it is very largely the custom to procure a table water of known 
purity and free from all taint. These are usually of certified chemical 
constitution, and are often both palatable and medicinal. After water 
has been boiled and the gases driven off, it is possible to aerate it again 



46 THE MAINTENANCE OF HEALTH. 

by pouring it backwards and forwards through a fine sieve so as to divide 
it into many small streams, and while thus exposed to the air it will 
absorb oxygen. If the water is only turbid, it may be allowed to settle, 
and the clear water carefully poured off. Hard water may be improved 
for drinking purposes by the addition of a little limewater. 

Mastication and Insalivation. — That the mouth by local care be 
kept in a normal, healthy condition is by no means of purely aesthetic 
interest. It is of vital importance to our general health, as indeed in 
many cases of severe and even serious dyspepsia the cause lies no deeper 
than the mouth, and the patient needs not pills for his stomach, but pellets 
for his decaying teeth. And while the field of medicine of to-day is 
broad enough without specializing in dentistry, every man who busies 
himself with the treatment of alimentary diseases should know enough 
about the teeth to be able to tell when the patient has mistaken the doctor's 
door for the dentist's. 

Among the various functions which are performed in the mouth, 
such as taste and the articulating of speech, we have one very important 
adjunct to the process of digestion. By the use of our teeth, cheeks, 
and tongue we chew our food and mix it with saliva, performing the 
functions of mastication and insalivation, constituting the first two steps 
in the process of digestion. And only after these two are thoroughly 
carried out should deglutition or swallowing occur. These three vol- 
untary acts are the only parts of digestion and nutrition over which we 
have any control, and it is ours to see that they are carried out in the 
most perfect manner, for here is the starting point of good digestion or 
of a dyspeptic constitution, as we choose to make it. Failure in this 
causes the whole body to suffer, for the stomach will receive food too 
coarse to act upon it. If it is not properly insalivated by the action of 
the saliva, it will pass it on to the intestines in such a condition that they 
in turn will be overworked, causing a general derangement of the various 
organs of assimilation and excretion, bringing about such maladies as 
are of grave constitutional importance by producing a condition of what 
is known as malnutrition. This is in the case of a large number of 
diseases a predisposing cause which can be traced to improper chewing 
and insalivation of our food. 

And while the serpent bolts his fly, the bird its grain, and the fish 
its brother without the ceremony of chewing, Nature has imposed upon 
us the work of mastication to meet the requirement of our higher organ- 
ization, and in no other particular is the perfection of creation more 



CARE OF THE TEETH. 47 

beautifully illustrated than it is in the adaptation of the various forms of 
teeth for the various purposes for which they were designed. 

Thus in the carnivora or flesh-eating animals, which spend but a 
short time in mastication, their teeth are in general adapted rather for 
tearing and cutting than for grinding, while in ruminating animals, 
whose teeth work all day long, most of them are especially adapted for 
grinding. But where the diet is partly animal and partly vegetable, as 
in man, the teeth are fitted for performing all kinds of work, — the front 
teeth being designed to cut, as they are sharp, and, in overlapping the 
lower teeth in closing, as the normal meeting of the teeth provides, they 
perform the work of a pair of shears, from which the name incisor 
(to cut) has been applied to them. Their immediate associates, the 
cuspids, commonly called eye and stomach teeth, being pointed, are 
adapted to the work of tearing, leaving the work of grinding to be done 
by our molars and bicuspids, whose broad, but uneven surfaces are so 
well adapted to complete this important function of mastication. 

In man there are two sets of teeth : the deciduous (from de and cado, 
to fall) or temporary teeth, sometimes called milk teeth, and the perma- 
nent teeth. 

The deciduous teeth are twenty in ^ 

number — ten in the upper and ten in _ /"'* ^N ,b 

the lower jaw — and consist on each ^^It^^S^^^iili^'^ 

side of four incisors (from incido, I cf ^^^iM^l^iX '^ 

cut), two canines or tearing teeth vMnlff ^^^m 

(from canis, a dog), so called because p^-^. ^^/^J 

they are well developed in the dog. *■' 

They are scientifically called cuspid „ FlG * lm 

. . Temporary or Deciduous Teeth. 

teeth (from the Latin cuspis, a spear), A Incisors> B CaninesorCuspid , CMolars . 

and four molars or grinding teeth 

(from the Latin mola, a mill), so called because they are for grinding 

purposes. 

Each of the deciduous teeth is, in the course of time, replaced by a 

permanent tooth, but not of the same denomination throughout, for the 

baby molars are succeeded by teeth which are now called pre-molars 

(from the Latin prae, before), meaning before molars, so applied because 

in the dental arch they come in rotation before the permanent molars 

as regards their position, but they are more commonly called bicuspids, 

having two cusps. And, in addition, the vacant portion of the gum back 

of the baby teeth is now filled up by twelve teeth, six on each side, three 



4 8 



THE MAINTENANCE OF HEALTH. 




Fig. 2. Permanent Teeth. 

A. Incisors. B. Canines. C. Bicuspids. D. Molars. 



above and three below these twelve permanent molars; they raise the 
number of the permanent teeth to thirty-two. And from before backward 
on each side, above and below, they are given the names of the first, 

second, and third molars. The 
-A i as t or third molar is more 

commonly called the wisdom 
tooth. 

Structure of Teeth. — Each 
tooth contains four structural 
substances : the enamel ; the 
dentine; the cementum; and 
the pulp. The enamel, which 
forms the outside shell of the 
crown, is the hardest substance 
within the body, being com- 
posed almost entirely of earthy 
or mineral (about 97 per cent), 
is made up of rod-like structure called enamel prisms, which radiate out- 
ward from the surface of the dentine at all points, being thickest at the 
grinding or cutting edges, and becoming thinner as it approaches the 
necks. 

The dentine represents the interior or middle portion of the tooth 
throughout its entire length. Its structure is similar to that of bone, 
but is harder and more dense. Dentine contains about 72 per cent of 
mineral matter, but is not nearly so hard as enamel. 

The cementum is the external covering of the root, completely envel- 
oping it as the enamel does the crown, and in structure it very much 
resembles the dentine. 

The pulp is the formative organ of the dentine. It occupies the 
central portion of the crown and root at about their junction, narrowing 
down gradually into a few nerve fibers and blood vessels, which pass 
out through the end of the root to connect with the large nerve 
trunk and blood vessels, of which it is a tributary part. This 
tissue is of much importance to the tooth because it is from this structure 
that it receives its blood supply and nerve vitality — its nourishment. 

The pulp tissue represents the incalcified portion of the original tooth 
germ. It is a highly organized, consequently an extremely sensitive 
tissue, and, when exposed by decay to the action of foreign bodies and 
to heat and cold, it is the source of excruciating pain. 



CARE OF THE TEETH. 49 

Causes of Decay. — It has been claimed upon very good reasoning 
that if it were possible to keep our teeth absolutely clean upon all sur- 
faces and at all times, there would be no decay of the teeth. Discussions 
at length have been held regarding the theory of decay of teeth, but 
present-day scientists seem to agree that it can be laid to the chemical 
and bacteriological theories alone, these two never working independ- 
ently. There is always an abundance of bacteria in the mouth, and in 
their presence there can always be found left an acid condition as their 
waste product, which, by its action to dissolve bone structure, penetrates 
the enamel, leaving a new surface with fresh organic matter for food 
for bacteria, which work together for the destruction of our teeth. 

The enamel, as above stated, contains only 3 per cent of organic 
matter, which is not enough to support bacterial life in itself, but when 
once the dentine is penetrated there is 28 per cent of organic matter in it, 
presenting a feeding ground for the millions of bacteria which inhabit 
the mouth. Under these most favorable conditions of heat and moisture 
they will multiply and thrive, still burrowing deeper until the pulp, 
being exposed, gives the possessor a gentle hint of the presence of a 
diseased tooth, which, when examined by the dentist, will probably 
require the removal of a nerve, causing the tooth to lose its transparency, 
as well as to make it brittle. Teeth should not be neglected until Nature 
warns us by pain, and the sooner people become educated to this fact 
the better will be the service they will receive from their dentists. 

Decay begins on the surfaces of the teeth and not on the inside or 
at the roots, as so many people erroneously believe. It begins, first, in 
crevices within the surface due to improper union of the enamel, which, 
being developed in segments, sometimes fails to form a proper and 
thorough union; second, it commences on surfaces which rest against 
other teeth where particles of food, principally of a starchy nature, lodge, 
and their inacessibility to a brush or other means of cleansing causes 
them to undergo a process of fermentation and decomposition and con- 
sequent disaster which follows. The usual point at which this condition 
is found is just above their contact points. 

Cleaning the Teeth. — Our teeth should be cleansed after each meal, 
and at least once a year by the dentist, who at this time can examine 
them thoroughly. 

Sometimes people flatter themselves with the thought that a tooth 
in which the nerve has become exposed by decay and has subsequently 
died of its own accord, will ache no more; but here begins the founda- 



50 THE MAINTENANCE OF HEALTH. 

tion for some of the most serious complications I have ever seen, as it 
is the starting point for a developing abscess of the jaw, which some- 
times proves very disastrous. I have in mind now a case of this kind 
which came to a public clinic with which I was connected at the time, 
and which was the direct cause of the patient having the entire 
lower jaw removed, defacing her expression in a most ghastly manner 
for life. 

Dead Teeth should either be extracted or thoroughly filled to be in 
a safe condition to keep in the mouth, and should be considered as dan- 
gerous organs to be retained in the mouth, both by reason of their poison- 
ous influence to digestion and of the danger of an alveolar abscess, which 
is liable, under favorable conditions, to develop at any time. 

Filling Teeth. — Teeth should be filled for their preservation so long 
as fillings can be retained in them, for crowning teeth must be resorted 
to as a last attempt to save them, as crowned teeth have a fixed and 
almost uniformly definite period of usefulness, which is ordinarily about 
fifteen to twenty years, oftener a much shorter time, when they become 
loosened by absorption and fall out, to be replaced by an entirely artificial 
substitute, and, as a wooden leg is better than no leg, so artificial teeth 
are better than no teeth, likewise a glass eye, a wig, a rubber nose, but 
the loss of the organ is none the less deplorable. 



THE CARE OF THE SKIN. 

The Skin and its Functions. — Because it is so actrve in throwing 
off refuse matter from the body, the skin has been described as the third 
lung. Its further uses are protective and absorbent. There are two 
layers of skin : the outer or scarf skin, sometimes called the cuticle ; and 
an inner skin, known as the true skin. The outer skin scarfs off in the 
form of dandruff and small scales. This explains why stains, such 
as that of iodine, so soon disappear. The skin is provided with two 
sets of glands : oil glands, which secrete a sort of oil to keep the hair 
oily and the skin soft and pliable; and perspiration glands, or pores, 
through which the perspiration passes and by which liquids are absorbed. 
The oil glands secrete a sebaceous matter which sometimes clogs up the 
glands and collects dirt, forming the unsightly blackheads. They are 
not found in those parts of the body which are devoid of hair, such as 
the soles of the feet and the palms of the hands. The perspiration glands 



BATHS AND BATHING. 51 

are extremely fine tubes, over two and a half millions in number, dis- 
tributed over all parts of the body. They are most numerous on the 
palms of the hands, and least so on the back of the neck and of the body. 
Perspiration, called insensible when it cannot be seen, and sensible when 
it forms drops, is constantly passing off from the body at the rate of 
about two pounds of liquid every day. If it is suddenly and temporarily 
checked, painful and dangerous results ensue; if permanently checked, 
death quickly follows. Actual breathing of oxygen gas and expulsion 
of carbon dioxide is carried on through the pores of the skin in the same 
manner as by the lungs. If all of the pores be closed so as to stop this 
process, death by suffocation will follow. This actually occurred in the 
case of a little child in a festival celebration at Rome, whose body was 
completely covered with gold leaf to represent the golden glory of an 
angel. Death followed in a few hours from suffocation by stopping the 
exhalations of the skin. Painter's colic is caused by the absorption of 
lead from the paint through the pores in the palms of the hand. The 
use of liniments containing opium is very dangerous, as the poison is 
absorbed by the skin, 'especially by raw surfaces. This absorbing power 
is active when the chest is rubbed with oil, or when skin food is applied 
to the body. The only way in which the pores of the body can be kept 
open and the activity of the skin insured is by frequent bathing. 

Baths and Bathing. — A state of good health cannot be maintained 
or secured unless the skin properly performs its several functions. This 
is impossible unless the skin is kept scrupulously clean. The cleansing 
process includes the removal of not only the accidental dirt but of the 
accumulated excretions of the skin itself. Part of the excretions are 
volatile, and either pass off into the air or are absorbed by the -clothing; 
and another part is non-volatile and can be removed from the skin only 
by washing. As this non-volatile part is very largely fatty in its nature, 
it cannot be thoroughly and effectively removed without the use of soap. 
As fatty matter is more soluble at a high temperature than at a medium 
or low temperature, warm water is more cleansing than is cold water. 
Friction by means of a flesh brush or by a rough towel is a great aid in 
the cleansing process. 

Cold Bath. — A cold bath is one in which the water is below 6o° 
Fahrenheit. Such baths abstract heat from the body, but, except in cases 
of very high fever, not to an extent appreciable by a thermometer, because 
the loss of heat by the body is made up by the increased heat production. 
This heat production is caused by, or produces, increased waste of tissue. 



52 THE MAINTENANCE OF HEALTH. 

or change of tissue. More carbonic acid is given off by the lungs; the 
pores of the skin are closed; the heart's action is at first quickened and 
then diminished ; and breathing is more rapid. The vigorous rubbing with 
a rough towel, which should instantly follow a cold bath, dilates or opens 
the pores of the skin, and a general stimulating and invigorating sensa- 
tion follows. The cold bath regularly taken, opens and closes the pores 
of the skin, and the power which the pores acquire in this respect render 
cold bathers little liable to take cold. Such are the good effects of a cold 
bath that is neither too cold nor too long continued, and upon the person 
of one who has sufficient vitality to react from the shock. Cold baths 
should not be taken by the very young, the very old, by those weakened 
by illness or disease, or by those already suffering from congestion. 
Those who suffer from disease of the heart should take only temperate 
baths. To those who can stand a cold bath, it should be the rule of 
their lives to take one daily, partly to cleanse the skin, and partly for 
the tonic effect upon the skin in particular, and to the whole body gen- 
erally. The best time of day for the full wash is on rising in the morn- 
ing. The body is then warm and better able to stand cold water than 
at any other time of the day; the muscles are relaxed by sleeping and 
the cold bath is bracing. 

Warm Bath. — A warm bath is one in which the temperature of the 
water is over 6o° and under 90 Fahrenheit. It dilates the pores of the 
skin and causes more rapid breathing. On leaving a warm bath the 
pores are still open and the perspiration is increased. There is then great 
need of care lest a chill be taken. The blood is withdrawn from the 
internal organs, and a sedative effect upon the whole body, with a feeling 
of sleepiness, is noticeable, so that a warm bath at bedtime is advisable 
in cases of insomnia or sleeplessness. Too frequently indulged in, warm 
baths are enervating, and the danger of taking cold is very great; but 
a warm bath is more cleansing than a cold bath, and after excessive exer- 
tion is useful to relieve the sensation of fatigue. It is best taken at night 
before retiring. 

Sea Bathing. — Sea bathing has all of the virtues of a cold bath with 
the added benefits of the moving water and the probable slight stimulating 
effect of the salt. The best time for a sea bath is about two hours after 
breakfast, and the bath should last not more than five minutes for those 
who cannot swim, and about ten minutes for those who can; in no case 
for more than fifteen minutes. The feeling of chilliness should be the 
signal for instant retirement from the water. The bather should then 



BATHS AND BATHING. 53 

dry himself and dress quickly. After cold or sea bathing, a little 
exercise immediately indulged in, is not only beneficial but essential. 

Turkish Bath. — The Turkish bath is intended to produce extreme 
perspiration with cleansing effect, to remove fatty matter from the skin, 
with attendant loss of weight. These baths must not be taken under any 
circumstances by those who suffer from valvular disease of the heart, 
aneurism, fatty degeneration of the heart, or by very old persons. There 
is very great danger of taking cold by going out into the cold air too 
soon after taking a Turkish bath. The establishments where these baths 
are given are usually provided with abundant means for resting and for 
allowing a sufficient time — certainly an hour at least — to elapse before 
exposing one's self to the dangers of cold air. Apart from any medicinal 
effect, the Turkish bath is a form of cleansing to be most highly recom- 
mended. The sweating in the hot room brings the dirt and fatty matter 
to the surface, and the subsequent thorough scrubbing with flesh brush and 
soap, and the flooding with w r ater, cleanses the skin and opens the pores. 

Hot Bath. — In a hot bath, the temperature of the water varies from 
90 to 112 Fahrenheit. It is not taken by persons in good health. Its 
effects are powerfully stimulating upon the vital processes, and, if sus- 
tained for more than ten or fifteen minutes, the hot bath is very weaken- 
ing. Its chief use is to induce perspiration with a view to alleviating a 
fevered condition. It is also beneficial in extreme cases of nervousness. 
The hot bath is generally administered by placing the patient in tepid 
water, the temperature of which is gradually increased. On the com- 
pletion of the bath, the patient is warmly wrapped in blankets. 

Shower Bath. — The cold shower bath is a greater shock to the system 
than is the cold all-over or plunge bath. The shock is greatly intensified 
by a large volume of cold water falling from a considerable height. The 
effects of this form of bath are very quickly felt, and are more far- 
reaching than are those of immersion. Such baths are usually arranged 
so that the temperature of the water may be varied and regulated as 
desired. When the shower is used as an adjunct of the Turkish bath, 
and is employed to reduce the temperature of the body gradually, warm 
water is first turned on and the temperature slowly lowered as the subject 
can stand it. Under no circumstances should the shower be long con- 
tinued. Its duration, when the water is cold, is not to be measured by 
minutes but by seconds. 

How to Make a Homemade Shower Bath. — Even in houses other- 
wise well provided with bathing facilities there is often no provision 



54 



THE MAINTENANCE OF HEALTH. 



made for the shower bath. The preparation of a shower bath is a very 
inexpensive matter. One must first choose a satisfactory place for it. 
Any place where provision can be made for catching the falling water 
is all that is required. A large tub in which the bather can stand while 
taking his bath will answer very well. Take a small-sized tub, one that 




Fig. 3. 
Details of Parts 
for Homemade Shower Bath. 



Ftg. 4. 

Parts of Shower Bath 

Put Together. 



will hold two or three buckets of water — a large-sized butter or lard tub 
is of a suitable size — and bore a hole in the bottom, near one side, large 
enough to contain the end of the pipe. Procure two pieces of iron pipe, 
one and one-half inches in diameter, and from ten to twelve inches in 
length, and an elbow to match. Fit the pieces of pipe into the elbow. 
Plug one end of the pipe with a piece of soft wood. Bore a hole through 
the plug of wood large enough to admit the end of an ordinary brass 
faucet. Cut a piece of tin to fit the end of a good-sized funnel. Per- 
forate this piece of tin with a number of holes. Solder the top thus made 
on the end of the funnel. Solder the small end of the funnel to the 
faucet. Insert the free end of the pipe into the hole in the bottom of 
the tub, and your shower bath is completed. The apparatus is to be 
placed at a convenient height, upon a beam, or a shelf. The ease of 
filling the tub must be considered in such arrangements as are adopted. 

Bath Thermometer. — The hand is a poor and unreliable test for 
the temperature of water for bathing, except in cases where there has 
been education and experience from long practice. For the hand is one 
of the most exposed parts of the body, and is not so sensitive to heat 
and cold as are those parts which are warmly clad. A most useful acces- 



BATHS AND BATHING. 55 

sory to the bath of both children and adults, therefore, is a bath thermom- 
eter. This is an ordinary thermometer encased in wood on three sides 
so that it floats easily in the bath and is protected from breaking against 




Fig. 5. Bath Thermometer. 

the metal sides of the tub. It is placed in the water and allowed to float 
for five minutes, when it is read in the ordinary way. The temperature 
of the water for the several sorts of bath is as follows : — 

Hot Bath, Over 98 Fahrenheit. 

Warm Bath, Between 90 and 98 Fahrenheit. 

Tepid Bath, Between 8o° and 90 Fahrenheit. 

Cool Bath, Between 65 ° and 8o° Fahrenheit. 

Cold Bath, Below 65 Fahrenheit. 

Russian Baths. — Russian baths are mainly vapor baths. The sub- 
ject is placed in a small room completely filled with hot steam, where he 
remains until a copious perspiration is induced. The body is then thor- 
oughly scrubbed and the temperature gradually lowered, the bath ending 
with a cold bath or shower. 

Sponge Bath. — Owing to a lack of conveniences, this is the only 
form of daily bath that can be taken by many persons. The requisites 
are a large basin full of good, soft water, a mild soap, a piece of face 
cloth or a sponge, one soft towel and one rough one. Use cold water in 
summer and tepid water in winter. The entire body is to be quickly 
rubbed over with the soaped sponge or face cloth. If the temperature 
of the room is low, a part of the body is to be washed and dried at a 
time, the rest being protected from the cold by clothing. After washing, 
the skin is first wiped dry with the soft towel, and then the rough towel 
is used briskly for four or five minutes, until the flesh is all aglow. The 
chest and the abdomen require the most attention in the rubbing, but 
the tenderness of the skin will determine the rigor of this treatment. 

Bath Room Accessories. — The water used in bathing is to be prefer- 
ably soft water. Hard water does not mix well with soap, is a poor 
cleanser, and is injurious to the skin. Usually, however, no choice can 
be exercised in this matter, as the bather is entirely dependent upon the 
water supply; but the addition of a little powdered borax will render 



56 THE MAINTENANCE OF HEALTH. 

hard water less disagreeable; and a very little pearline will greatly 
increase the cleansing power of all water. 

Soap. — No very cheap soap can be good soap. That which is to be 
used on the face especially should be of the best quality obtainable. The 
chief quality that all soap should possess is that it contains no free alkali. 
In the manufacture of soap an alkali is mixed with oil or grease. If 
more alkali than is needed is used to mix with the oil or grease, some of 
it will be free, and in that form it has a caustic, burning effect upon the 
skin. Good, pure soap is one of the little luxuries of life that all should 
try to afford. A simple test of free alkali in soap is to hold the soap 
for a moment to the tip of the tongue ; if free alkali is present a burning 
sensation will quickly be felt in the tongue. Highly scented soaps, espe- 
cially those of a cheap grade, should be looked upon with suspicion, as 
the heavy, cheap perfumes used in their manufacture admit of the use 
of an inferior and objectionable grade of oil or grease. 

Face Cloths. — Face cloths are preferable to sponges, as they are 
much more easily cleansed and dried after use. The chief use of the 
face cloth or sponge in bathing is to insure a complete removal of the 
soap from the skin after bathing. 

Flesh Brush. — This is indispensable to a good cleansing bath. 
Friction is needed to remove obstructions of fatty matter and secretions 
which choke up the pores of the skin, and which, if permitted to remain, 
produce pimples and blackheads. No properly performed bath is pos- 
sible without this aid. 

Face Brush. — A softer form of flesh brush, made of camel's-hair, is 
of great service in bathing the face. A vigorous rubbing of the face 
with this, and the use of hot water and good soap, will do vastly more 
than cosmetics to produce a fine complexion. The regular use of the 
face brush produces a satin-like bloom that no art can supply. 

The Complexion. — The great cause of a lack of beauty lies not so 
much in irregular contour of the features, or in lack of expression, as in 
the bad condition of the skin. This, so far as the face is concerned, is 
called the complexion. Too often, neglect to care properly for the skin 
of the body brings eruptions and blemishes upon the face. Of course 
a woman is abundantly justified in temporarily concealing the eruption 
or blemish by all the means in her power; but she is not justified in 
neglecting to instantly and intelligently attack and remove the cause of 
such blemishes. That cause is most likely to be found in some irregular- 
ity of diet, especially in the consumption of large quantities of pastry. 



FRECKLES. 57 

Abstinence from this, in its several seductive forms, and attention to 
the condition of the blood, will work wonders in this direction. A good 
fruit diet, green vegetables, and hot water, to take the place of sweets, 
tea, coffee, fats, and the like, is a sure cure. Saline purgatives, Rochelle 
salts, cream of tartar, sulphur soap and ointments, tar ointment, persist- 
ently used for a time, will abundantly repay all trouble and self-denial. 

Cream for Pimples. 

Lanolin, 8 ounces. 

Sweet Almond Oil, 8 ounces. 

Precipitated Sulphur, 8 ounces. 

Oxide of Zinc, 4 ounces. 

Extract of Violet, 15 drops. 

A very little of this ointment carefully applied to the pimples at even- 
ing will be found very effective. Refrain from the use of the face brush 
and other irritations until cured. 

Summer Rash. — There is an annoying form of pimple accompanied 
by a redness or rash, which usually comes upon the face and neck in 
summer. It is prevented by attention to the diet, as it is caused by 
irregularities in eating. Starchy foods, much meat, and heating foods 
of all sorts are to be avoided. 

Freckles. — There are two sorts of freckles, — temporary and per- 
manent. Temporary freckles appear after exposure to winds and strong 
sunlight; they usually disappear with shade and protection. Bathing 
the face frequently with soft water and pure soap, with liberal and ener- 
getic use of the face brush, will so stimulate the circulation of the blood 
that these freckles will soon disappear. Their removal may be hastened 
by the application of the cream and lotion given below. The cream is to 
be applied at night on retiring and the lotion several times, during the 
day : — 

Cream for Freckles. 

Ointment of Elder Flower, 1 ounce. 

Sulphate of Zinc, 20 grains. 

Lotion for Freckles. 

Infusion of Roses, 8 ounces. 

Citric Acid, 30 grains. 

This lotion is to be kept in a close stoppered bottle. If it irritates 
the skin, relief will be afforded by the use of the following : — 



58 THE MAINTENANCE OF HEALTH. 

Healing Lotion. 

Boracic Acid, i dram. 

Witch Hazel Extract, 2 ounces. 

Rose Water, 2 ounces. 

Permanent Freckles. — The permanent freckle usually appears in 
winter and the cool weather. It can be removed only by the removal of 
the outer skin. This can be done without pain, although the applications 
will cause redness of the skin and some irritation while they are being 
used. When this occurs, the condition will be at once relieved by the 
use of the healing lotion given. 

Wash for Permanent Freckles. 

Lactic Acid, 4 ounces. 

Glycerine, 2 ounces. 

Rose Water, 1 ounce. 

This is to be applied carefully to each freckle so as not to involve 
the surrounding clear skin. The irritation which this will most likely 
cause may be allayed by using the following : — 

Ointment. 

Oil of Almonds, 4 ounces. 

Vaseline, . .3 ounces. 

Spermaceti, 1 ounce. 

Melt and add 

Tincture of Benzoin, 15 drops. 

Chapping. — Chapping of the skin of the face is prevented by the 
use of a veil as a protection against cold winds. The following cream 
is delightfully soothing for chapped face and hands : — 

Cream for Chapped Face and Hands. 

Spermaceti, J4 ounce. 

White Wax J4 ounce. 

Almond Oil, ]/\ pound. 

Cocoa Butter, Y\ pound. 

Lanolin, 2 ounces. 

Melt and add 

Balsam of Peru, 1 dram. 

Let it settle. Pour of! the clear liquid and add 

Orange Flower Water, 2 drams. 

Stir until it solidifies. 

Apply two or three times a day with a piece of soft cotton cloth or 



BLACKHEADS. 59 

flannel. The face may be bathed in tepid water, with a little soap, an 
hour after each application. 

Tan and Sunburn. — Tan and sunburn may be removed by this 
lotion : — 

Lotion for Tan and Sunburn. 

Borax, 10 grains. 

Limewater, 2 ounces. 

Oil of Sweet Almonds, 2 ounces. 

If the skin is inclined to "peel" from the effects of the sunburn, after 
using this wash twice a day, the following wash, used every morning 
after washing, will relieve the condition : — 

Lotion for Peeling Skin. 

Sal Ammoniac, 2 drams. 

Alcohol, 2 ounces. 

Rose Water, 1 pint. 

Venetian Talc, 1 ounce. 

Yellow or Liver Spots. — Large yellow spots that form on the skin 
are produced by inactivity or irregularities of the liver. Small doses of 
calomel and the application of either of these lotions will soon cause them 
to disappear : — 

Wash for Liver Spots. 

Kaolin, 1 ounce. 

Lanolin, 1 J4 ounces. 

Glycerine, 1 ounce. 

Carbonate of Magnesia, y 2 ounce. 

Oxide of Zinc, J^ ounce. 

Apply at night on retiring and allow it to remain all night. 

Wash for Liver Spots. 

Oleate of Copper, 15 grains. 

Oxide of Zinc Ointment, y 2 ounce. 

Apply every night and morning. 

Blackheads. — Blackheads are formed in the obstructed pores of the 
skin, and consist of fatty matter surmounted by black accumulations of 
dirt. They are best removed by treating the skin for two or three weeks 
with the following cream, to soften the skin : — 

Cream for Softening the Skin. 

Lanolin, 1 ounce. 

Almond Oil, 1 ounce 

Tincture of Benzoin, V2. ounce. 



60 THE MAINTENANCE OF HEALTH. 

Mix and rub well into the skin night and morning. This applica- 
tion is intended to so soften the skin that the blackheads may be squeezed 
out without danger of rupturing the delicate tissues or of leaving small 
scars. Wash the face well with good soap and hot water before apply- 
ing the cream. If after two or three weeks' treatment, the skin is not 
sufficiently softened to permit of squeezing the blackheads out by gentle 
pressure, recourse must then be had to green soap. The face is first to 
be bathed in water as hot as can be borne. Cloths wrung out of hot 
water are then to be applied and frequently renewed. This is to be con- 
tinued for fifteen minutes. The green soap is then applied by rubbing 
it well into the pores of the skin. It is a soft, jelly-like substance, pro- 
curable at all drug stores. The soap is then well rinsed from the face 
by several waters and with a free use of the face brush. This not only 
removes the soap from the pores but brings many of the blackheads away 
at the same time. The cream mentioned above is then applied to the 
skin, and the operation is repeated each night until all the blackheads 
have disappeared. 

Wrinkles. — A wrinkle is usually caused by the falling away of the 
adipose or fatty tissue between the skin and the muscles through weak- 
ness, disease or age. Age has been spoken of as that period of life when 
the waste of tissues is greater than the repair. Consequently wrinkles are 
to be expected after sixty. Prior to that they may be regarded as pre- 
mature. Then we must look for other causes which are capable of 
being removed. Those wrinkles that are an indication of character and 
temperament, if characteristic of undesirable qualities, can be removed 
only by the exercise of the opposite benevolent trait, which simply means 
a decided change in character and disposition. Those that are charac- 
teristic or indicative of good qualities are by no means to be considered 
as blemishes. A countenance devoid of lines is expressionless and un- 
attractive. 

Besides the wrinkles which are to be considered as the character lines 
of the face, there are lines and wrinkles formed by little habits and tricks 
of manner, which can be removed permanently only by stopping the 
objectionable practices. Then there are those wrinkles which come from 
illness, anxiety, care, and fretfulness. 

The great principle underlying, the removal of wrinkles is the improve- 
ment of the general health and observance of the laws of hygiene. By 
such means the layer of adipose tissue which gives roundness and fullness 
to the face and body, and which has disappeared, is to be restored with 



CLOTHING. 61 

a view to filling out the hollows and vacancies between overlying muscles. 
Supplement these means with careful and skillful massage, the applica- 
tion of a good skin food, physical culture, and the cultivation of a happy 
disposition, and, probably, all of the available and requisite means are 
enumerated. 

Skin Food for Wrinkles. 

White Wax, i ounce. 

Spermaceti, i ounce. 

Lanolin, 2 ounces. 

Sweet Almond Oil, 4 ounces. 

Cocoanut Oil, 2 ounces. 

Tincture of Benzoin, 3 drops. 

Orange Flower Water, 2 ounces. 

Melt together the solids and the oils; beat until nearly cold; mix the 
benzoin and the orange flower water and add it a little at a time while 
beating. 

This is a valuable tissue builder to be used with massage when the skin 
is dry and wrinkled. There are many mechanical appliances for admin- 
istering massage but none of them is comparable to the manual method. 

Warts. — These are to be removed by tying a string around them 
when they are pendulous, or hanging by a stalk ; the string is to be worn 
until the wart falls off by reason of the stoppage of the supply of nour- 
ishment upon which it feeds ; or, when flat, the wart may be treated with 
nitrate of silver or lunar caustic. This comes in the form of a white 
pencil. The end of it is dipped in water and rubbed over the surface 
of the wart. On exposure to light the nitrate of silver turns jet black. 
Care must therefore be taken that the treatment is confined to the wart, 
and that the surrounding tissues are not touched. As the caustic burns 
the wart away, the surface of the wart is to be pared with a sharp knife 
and the treatment applied anew to the fresh surface. Care must be 
taken that the paring does not cause the wart to bleed. Other strong 
escharotics, such as strong or glacial acetic acid, nitric acid, caustic potash, 
tincture of iron, and hydrochloric acid, may be used by those who know 
something about their properties. But, as they are extremely dangerous 
in their effects if wrongly used, the caustic treatment is to be preferred. 

CLOTHING. 

As it is a part of the office of the clothing worn next to the skin to 
take up the perspiration and exhalations of the body, it follows that 



62 THE MAINTENANCE OF HEALTH. 

frequent change of this is not only advisable on the score of comfort, 
but is absolutely necessary to health. The exhalations from the bodies 
of some persons, are quite profuse and offensive in odor. Especially is 
this true of the emanations from the feet even in spite of all attempts 
at cleanliness. Frequent changing of the garments, then, becomes im- 
perative. If the feet perspire copiously this may be checked by bathing 
the feet daily in water in which a small piece of alum has been dissolved. 
This has the effect of closing the pores by the astringent or puckering 
power of alum. The offensive odor may be gotten rid of by shaking 
talcum powder into the socks or stockings and shoes each day. The 
shoes should be dried out frequently, as the perspiration accumulates in 
them sometimes to an offensive degree. 

The underclothing in winter should be of wool ; and even in summer, 
wool or a mixture of wool and cotton known as merino, should be worn. 
Some skins are so tender that they will not bear wool next to it. Silk 
is ideally comfortable in summer, but, unfortunately, is debarred by its 
expensiveness. Woolen clothing worn next to the skin is almost a 
sure guarantee against chills after overheating or in cold weather. The 
danger of a chill is one of the greatest risks to which we are exposed, as 
it nearly always means at least a cold, and sometimes pneumonia or 
inflammation. Cotton garments when damp from perspiration become 
cold and uncomfortable; but, as was rather paradoxically said of a 
woolen undergarment, "It is always dry and warm no matter how cold 
and wet it is." The chief objection to woolen garments is that, even 
though great care be taken in washing them to prevent shrinking, they, 
in time, become stiff and hard, losing the absorbent properties which 
make them so comfortable and healthful. 

In cold weather woolen clothing is warm by reason of the pores or 
cavities in the fabric in which the air lodges; and air is one of the best 
non-conductors of heat. For, in addition to the necessity of keeping 
the cold out, much of one's comfort in winter depends upon keeping the 
warmth of the body in. A tightly fitting coat buttoned up is warmer 
than a loose fitting garment, as the former keeps a layer of non-conducting 
air next to the body. For the same reason two thin woolen garments are 
warmer than one thick one. 

In summer, light-colored clothing of cotton or linen is much cooler 
than dark-colored or woolen clothing. 

The great danger of taking cold lies in sudden changes of temperature 
where the climate is so variable that one does not know quite how to dress 



CLOTHING. 63 

for the day. But in such cases it is rather better to err by providing 
clothing which is uncomfortably warm than to risk exposure in clothing 
that is too thin. 

Many attempts have been made from time to time to introduce sani- 
tary and hygienic clothing, but these efforts have been attended with but 
slight success. Not that the suggestions were not practical or meritorious 
from a sanitary and hygienic standpoint, but that the shapes and styles 
proposed were so much at variance with the prevailing fashions that no 
one had the desire or temerity to adopt them. 

It is generally true that women are not nearly so warmly clad as are 
men. This is, perhaps, because of the fact that they are not exposed to 
the rigors of climate and to the inclemency of the weather so much nor 
for so long a time as men are ; and also for the reason that it is a physio- 
logical fact that they have a much thicker deposit of subcutaneous fat 
than men have. At all events the dictates of fashion and the social 
demands appear to make them run very great risks on occasion. Cer- 
tainly the thin-soled slippers, thin stockings, low-necked and short-sleeved 
gowns in which they are so often seen in bad weather justify the fears 
that they do expose themselves injudiciously in compliance with the con- 
ventionalities of life and the customs of society. 

For protection against rain, the best material is one that will keep 
out the wet, and, at the same time, allow the perspiration and exhalations 
from the skin to pass off. The clothing must not be of such a nature as 
to permit rapid drying by evaporation while on the body ; for evaporation 
absorbs heat and causes a chill, which must always be avoided. So far 
as the perspiration is concerned, there should be rapid absorption and 
slow evaporation; and, regarding the rain, slow absorption and slow 
evaporation. Wool meets these requirements better than any other fabric. 
The wool is porous and therefore absorbs a great deal of water; being 
thick the water does not evaporate too quickly. In addition, the wool is 
warm. When woolen garments are treated with the well known water- 
proofing process, their efficiency as a protection against rain is increased. 
Waterproof materials of the rubber variety are objectionable because they 
are not porous and do not allow the perspiration either to be absorbed or 
to pass off. 

It is essential that the feet be kept dry. Snow water is more pene- 
trating than rain water. Under no conditions should one sit with either 
damp or cold feet. Dry, warm woolen socks or stockings should be put 
on at once. In the case of women, very often the edges of the skirts 



64 THE MAINTENANCE OF HEALTH. 

become wet from rain or snow. The skirt should be changed, if possible, 
but certainly should be dried at once. 

No one should sit for any length of time with rubber overshoes on. 
These exert an uncomfortable drawing effect upon the feet, and are 
weakening. By reason of their being air tight, they interfere with the 
necessary ventilation of the feet. Bad effects are produced when chil- 
dren are permitted to wear rubber overshoes during school sessions. 

Tight Neckwear. — A great deal of eye trouble and headache is 
directly traceable to the wearing of tight collars and other neckwear. 
These have the effect of constricting the throat and of interfering with 
the circulation of the blood. The neck is provided with large and impor- 
tant blood vessels which supply the brain and some organs of special 
sense. If this fresh supply is prevented from reaching the brain, or if 
the return of the impure blood from the brain is impeded, as is often the 
case when bending or stooping over a tight collar, the effects are neces- 
sarily injurious. The effect is quite the same as when a string or rubber 
band is tightly tied around the finger. The constriction of the blood 
and its retention and congestion in the head produce many eye troubles 
and headaches. 

Changing Underclothing. — It is the habit of many people to change 
the underclothing for a lighter or heavier weight at the change of seasons. 
There are some, however, who wear the same weight all the year around, 
and who regulate their health and comfort by the weight and number of 
the outer garments. Where the change is made, especially from a heavy 
to a lighter weight, it must be done with care and judgment. It is best 
to make the change in the morning on rising, and to select a fine, mild 
day for the purpose. These conditions are most favorable and least 
dangerous. 

Hardening Children. — The habit of dressing children rather lightly 
for the purpose of hardening them and of inuring them to cold, very 
often falls little short of cruelty and inhumanity. If immediate bad 
results from this practice are not noticeable, parents are often inclined 
to think well of it and do not take into consideration that they are plant- 
ing the seed of future disease and are undermining the child's health. It 
is most reasonable that the use of short stockings and the exposure of 
several inches of bare legs to cold winds in chill weather must be not 
only uncomfortable but decidedly dangerous. It is a safe rule in the 
dressing of children for protection against cold to clothe them as far 
as possible in woolen garments throughout. 



CARE OF THE HAIR. 65 

Too Much Clothing. — On the other hand, there is a possibility of 
overclothing* one's self. The proper protection in a variable climate 
requires care, judgment, and observation. The greatest safety lies in 
uniformity under like conditions. Wrapping and bundling up the throat 
and neck is dangerous, not so much from doing it, as from the neglect to 
do it on a cold day after the organs have become accustomed to the protec- 
tion. One's own comfort is a safe guide to follow in the matter of clothing. 

Exercise and Food. — It is by exercise and proper food that the body 
is invigorated and not by insufficient clothing and exposure. Nor should 
weight of clothing be mistaken for warmth. Laboring under this mis- 
taken notion, feeble persons are often seen exhausted and weakened by 
an incredible weight of clothing. Especially is this mistake prevalent in 
the matter of bed clothing. One is more likely to be deceived in this 
connection by cotton clothing and fabrics than by woolen goods. 

Tight Waist Clothing. — Much has been written and spoken against 
wearing tight garments and supports around the waist. A general tirade 
and an energetic crusade have been conducted with little effect against 
the corset. Corsets have always been worn by civilized races, probably 
always will be worn; fashion dictates their use, and women require the 
support which they give. But all of this does not lessen or justify the 
injury of excessively tight lacing by women, or the tight belt which the 
summer or negligee dress of men has so much encouraged. In these cases 
the constriction of the waist and abdomen displaces the organs and pre- 
vents deep abdominal breathing. The breathing of women differs essen- 
tially from that of men. Woman's breathing is largely chest breathing. 
Few of them know the pleasure and value of deep, hearty breaths, and 
on this account the regular practice of breathing and chest expansion 
exercises, night and morning, are strongly recommended. 

CARE OF THE HAIR. 

The hair is designed as a protection against heat, cold, and injury 
from blows. It is a modified or changed form of the cuticle or skin. 
It is found on all parts of the body except the palms of the hands and 
the soles of the feet. The luxuriance of growth varies greatly in dif- 
ferent persons and is largely influenced by heredity, temperament, and 
constitution. Each hair is tubular in shape, and is composed of hard, 
colorless scales, which overlap one another like shingles on a roof. The 
interior of the hair is hollow or porous. Buried well down in the true 



66 THE MAINTENANCE OF HEALTH. 

skin is a bulb, the papilla, where the growth of the hair proceeds at the 
rate of from five to seven inches a year by the constant formation of 
numerous cells. When a hair is pulled out, this bulb is seldom injured, 
but produces a new hair. If the papilla is in any way injured or de- 
stroyed, the hair can never giow again. The lower part of the bulb is 
supplied with small nerve and blood-vessel connections for both sensa- 
tion and nourishment. The space around the bulb is the true seat of 
growth and of life, and is known as the follicle. A little above these 
parts is a small muscle interlaced among the fibers of the skin. These 
small muscles contract with cold and under other influences. This con- 
traction puckers the skin and causes the hair "to stand on end." Above 
this are the two oil or sebaceous glands which secrete an oil to keep the 
hair soft. 

Baldness is due to the death of the follicle, and the peculiar shiny 
appearance of the scalp is a sign that this stage has been reached. No 
effort will then produce a new growth of hair. When baldness begins 
there is necessity of arresting the process and of taking good care of 
the hair that is left. 

Color of the Hair. — The color of the hair is due to the presence of 
a mineral ingredient in the pigment, or coloring matter, in the cells. It 
is said that the various colors of the human hair have all been caused 
by the mixture of three primary colors : red, yellow, and black. Yellow 
hair has the yellow coloring matter alcne; browns, reds, and dark hair 
are composed of varying mixtures of all three; and the blackest of all 
hair has some red coloring matter mixed with the black. Chemical 
analysis shows that yellow or very light hair is colored by salts of mag- 
nesia; the browns and dark hair owe their color to the presence of 
sulphur; and black hair is so colored by iron. These mineral coloring 
matters are affected by both age and health in this order : iron, sulphur, 
magnesia. Accordingly it is observed that black hair usually turns gray 
first, and blond hair retains its original color much later in life than the 
other shades. 

Cleanliness. — There is a prevalent prejudice against washing the 
hair on the ground that washing removes the oil from the hair and tends 
to make the hair dry, brittle, and liable to split. If the washing is done 
in such a way as to bring about these results, it certainly is injurious. 
But it is the method that must be changed rather than the practice stopped. 
Absolute cleanliness of the scalp is necessary to the healthy growth of 
the hair. The scalp is a part of the skin. It has its exudations of per- 



WASHING THE HAIR. 67 

spiration and of fatty matter just as the rest of the body has. The 
accumulation of this matter and the clogging of the pores is quite as inju- 
rious in the scalp as in any other part of the body, and the removal of 
the matter is just as necessary. There is also an accumulation of acci- 
dental dirt on the scalp and the adherence of particles of dust and dirt 
to the hair which must be removed. 

It is not by the practice of washing the hair once a week that the 
injury is done, but by the use of much soap and ammonia and other 
harmful ingredients of shampoos that this condition of the hair is often 
brought about. Some consider that the use of the brush and comb is 
sufficient to keep the hair clean. The object of the comb is to straighten 
the hair and to prevent matting and tangling. It also produces some 
slight electrical stimulation at times. The comb should not be used to 
violently scratch the scalp, as this sets up inflammation and causes a 
heavy growth of dandruff as well as an annoying irritation. The brush 
is intended to evenly distribute the natural oil of the hair throughout its 
length, and, while the brush should be fairly stiff to perform this work, 
it should not have wire bristles, as these are more harmful than the 
harshest possible use of the comb. The natural oil of the hair is quite 
as well able to withstand the application of water as are the feathers on 
the back of ducks and other aquatic birds. Water without soap will not 
affect the oil of the hair, for oil and water do not mix. If a lather is 
desirable in washing the hair, it can be produced most abundantly by 
using the white or the yolk of an egg. After the hair has been thor- 
oughly wet with the water the egg is applied and well rubbed in. The 
lather which results has great cleansing power on both the scalp and the 
hair without disturbing the oil of the hair. When the lather is well 
washed out, the hair and scalp are both in splendid condition. The 
albumen of the egg has also some effect in soothing any irritation which 
may exist, for it is a good emollient application to inflamed surfaces. 

Dandruff. — This is a natural formation on the scalp and is not a 
disease. But if the deposit is excessive so that it cannot be removed by 
ordinary cleansing methods this indicates an unhealthy condition of the 
scalp. In obstinate cases either of the following applications will be 
found helpful and efficient :— 

For Dandruff. 
Yolk of one egg. 

Hot Rain Water, 1 pint. 

Spirit of Rosemary, 1 ounce. 



68 THE MAINTENANCE OF HEALTH. 

Beat the mixture together thoroughly, and, while warm, rub it well 
into the scalp. Rinse well in several waters. 

To Prevent Dandruff. 

Oil of Rosemary, i dram. 

Liquor Ammonia, 2 drams. 

Glycerine, . . . 1 ounce. 

Oil of Thyme, 1 dram. 

Tincture of Cantharides, 2 ounces. 

Mix with 12 ounces of rose water. Apply this well to the scalp, 
rubbing it in vigorously. Continue its use until the dandruff disappears. 

Dandruff Lotion. 

Tincture of Cantharides, ■ T / 2 dram. 

Solution of Carbonate of Potassium, iy 2 drams. 

Extract of Rosemary, 1 dram. 

Distilled Water, 4 ounces. 

This is to be applied and well rubbed into the scalp after the hair 
has been thoroughly washed. 

Ventilation. — The hair like other parts of the body requires to be 
well ventilated. Fresh air must have access to the scalp, and the ema- 
nations from the pores of the scalp must be permitted to escape. This 
is true of all parts of the body, but the penalty exacted for its violation 
in regard to the scalp is greater by the weakening of the hair and its 
ultimate loss if persisted in. Consequently heavy headgear, wearing the 
hat in the house and office, and the tight coiling of the hair by women 
are injurious to the hair. The removal of the hat on occasions, to which 
good manners obligates men, is, therefore, beneficial to them. It is 
claimed by many scientists that ill ventilation of the scalp is one of the 
most fruitful causes of baldness. The necessity of keeping the head cool 
at all times has passed into a proverb; but experience shows that too 
often a proverb slips glibly from the tongue without making much 
impression on the mind. 

Friction and Massage. — The point at which friction of the scalp, 
or scalp massage, is directed is the circulation of the blood in the scalp. 
The indications of imperfect circulation are : dryness of the hair, brittle- 
ness and consequent breaking and splitting of the hair, excessive oiliness, 
and persistent dampness at the roots of the hair from perspiration. When 
it is remembered that the circulation of the blood through the scalp is the 



CARE OF THE HAIR. 



69 




means by which the tissues are fed 
and nourished, it will be easily seen 
that, if the circulation is imperfect, 
the whole tissue and all of its de- 
pendents will suffer; and that if the 
circulation is restored to its normal 
condition, growth will be stimulated 
and decline and decay will be ar- 
rested. Scalp massage, if properly 
performed, will do that very thing. 



Fig. 



6. Massage of the Hair. 
First Movement. 



The stimulation of the blood vessels 
in the scalp by massage is compara- 
tively easy, since there is a strongly 
resisting surface of bone throughout 
against which gentle pressure is ex- 
erted. It is not nearly so hard as to 
treat by massage those deep-seated 
vessels which are surrounded by soft 
yielding tissues in other parts of the 
body. 




Fig. 




7. Massage of the Hair. 
Second Movement. 



Fig. 



Massage of the Hair. 
Third Movement. 



Ill administering scalp massage, 
the hair, if long, should be loosened 
and parted in the middle. The fin- 
gers are placed close together, with 
the tips upon the scalp, and gently 
forced into and upon the scalp from the 
crown towards the forehead. The en- 
tire surface of the scalp is gone over 
in this manner. 

Next the tips of the slightly sepa- 
rated fingers of both hands are pressed 
into the scalp with a rotating motion. 
This treatment is applied to the entire 
surface of the scalp. 

The fingers are then separated, and 



yo THE MAINTENANCE OF HEALTH. 

the head is struck gently with a sidewise action of the hand, the little 
finger of both hands striking the scalp first. At the moment of striking, 
the other fingers loosely held, strike against the little fingers only. This 
has the effect of a series of blows, gentle at first, but cumulative in their 
effects when rapidly performed. This treatment is given to the entire 
scalp. 

Itching. — The itching of the scalp, which usually accompanies the 
excessive formation of dandruff, is extremely annoying and uncomfort- 
able. There is strong probability that it is occasioned by a parasite. If 
this be the cause, it will quickly respond to a few washings with bichloride 
of mercury soap, or, as it is often called, sublimate soap. This is a good 
agent for killing parasites and also for relieving itching of the skin in 
other parts of the body from other causes. 

Falling Hair. — This is to be regarded as a sign of general debility 
and of failing health, but only when it is persistent. It does not apply 
to the occasional falling of the old hair which is displaced at times by 
a new growth. There need be no alarm over the matter unless the fall 
of hair continues. It frequently follows fevers and other weakening 
diseases. It must be, first of all, attacked by building up the system with 
a good course of tonic medicines taken internally. Sometimes the cutting 
of the hair is necessary, and, in the case of men, this should be done fre- 
quently. Cleanliness is to be faithfully observed, and one of the follow- 
ing lotions may be applied with advantage : — 

For Falling Hair. 

Eau de Cologne, . . . 2 ounces. 

Tincture of Cantharides, .2 drams. 

Oil of Lavender, 10 drops. 

Oil of Rosemary, 10 drops. 

Mix thoroughly and rub a little into the scalp night and morning. 

For Falling Hair. 

Beef Marrow, 6 ounces. 

Nervine Balsam, 2 ounces. 

Peruvian Balsam, 2 ounces. 

Oil of Almonds, 1 J / 2 ounces. 

Extract of Cantharides, 16 grains. 

Melt the marrow and the nervine balsam in the oil; strain and add 
the Peruvian balsam, and, lastly, the extract of cantharides dissolved in 
one dram of rectified spirits, 



CARE OF THE HAIR. 71 

Rub the pomade into the scalp night and morning for a week. Too 
frequent, or too liberal, application will cause soreness. In that event 
use less and apply only once a day. 

For Falling Hair. 

Fresh Lemon Juice, 1 dram. 

Extract of Peruvian Bark, 2 drams. 

Beef Marrow, 2 ounces. 

Tincture of Cantharides, 1 dram. 

Oil of Lemon, 20 drops. 

Oil of Bergamot, 10 drops. 

Mix by melting and stirring. Wash the head and dry thoroughly 
at night. Next morning apply a little of the pomade and rub well in. 
Continue the application for four or five weeks. 



For Falling Hair. 

Burnt Alum, iy 2 drams. 

Biborate of Soda, iy 2 drams. 

Beef Marrow, 1 ounce. 

Essence of Bergamot, 6 drops. 

Mix by melting and stirring. Rub well into the scalp night and 
morning. 

For Falling Hair. 

Oil of Mace, iy 2 ounces. 

Olive Oil, . .- 2 drams. 

Aqua Ammonia, 1 y 2 drams. 

Spirits of Rosemary 1 ounce. 

Rose Water, 2^ ounces. 

Mix and rub well into the scalp night and morning. 



For Falling Hair. 

Bay Leaves, 2 ounces. 

Whole Cloves, y± ounce. 

Spirit of Lavender, 4 ounces. 

Spirit of Thyme, 4 ounces. 

Mix and allow to stand for six days, shaking the mixture well once 
a day. Filter, or strain through very fine cloth. Add half an ounce of 
ether. Apply a little night and morning, rubbing well into the scalp. 



J2 THE MAINTENANCE OF HEALTH. 

For Falling Hair. 

Hydrochlorate of Jaborandi, 6 grains. 

Tincture of Jaborandi, 4 drams. 

Spirit of Rosemary, 2 drams. 

Vaseline, 4 ounces. 

Alcohol, 4 ounces. 

Apply every night. Rub well into the scalp. 

For Falling Hair. 

Eau de Cologne, 8 ounces. 

Tincture of Cantharides, 1 ounce. 

Oil of Lavender, Y 2 dram. 

Oil of Rosemary, y 2 dram. 

Mix. Shake well. Rub into the scalp twice a day. 

For Falling Hair. 

Castor Oil, . 1 ounce. 

Bay Rum, 1 ounce. 

Tincture of Cantharides, 1 dram. 

Mix. Shake well. Rub into the scalp night and morning. 

Gray Hair. — Heredity has much to do with prematurely gray hair. 
Although, after the tricks of heredity, the inheritance may skip a genera- 
tion, and the fact that one's father or mother was not gray is no proof 
that heredity has nothing to do with this special case. One must look 
farther back before deciding. Well authenticated cases are on record of 
the sudden changing of the hair under the influence of fright, grief, 
illness, and anxiety. Sometimes the change is gradual and the beginning 
of it may date from one of these influences. Some people object to the 
intervening stages of yellowish gray color through which the hair gen- 
erally passes and seek to change the color to white at once. There is no 
way known by which this can be done without injury to the hair. Gray 
Jiair may be slightly darkened by the use of one of the following applica- 
tions, but they are in no sense of the word hair dyes : — 

For Darkening the Hair. 

Glycerine, . . 1 ounce. 

Rose Water, 1 ounce. 

Mix and rub well into the roots of the hair each morning. This is 
not at all injurious, and is sometimes used for darkening hair which has 
not turned gray. 



CARE OF THE HAIR. 73 

For Darkening the Hair. 

Green Tea, i ounce. 

Freshly Dried Sage, i ounce. 

Rain Water, I pint. 

These are to be boiled in an iron \*essel and allowed to stand in it for 
24 hours. Rub well into the roots of the hair night and morning. 

Homemade hair dyes are rarely a success. The changes of the com- 
plexion and of the skin keep pace with the changes of the hair. When 
the latter is dyed, ever so successfully, there is at once such a subtle, per- 
ceptible lack of harmony between the complexion and the dyed hair that 
no one is deceived by the practice. Gray hair, when well kept, is becom- 
ing, and is regarded with more and more esteem every year. When a 
dye is not well applied, the hair streaks, and if the hair is not regularly 
treated, the gray roots of the hair are sure to be most conspicuous. The 
dyes which contain lead are positively injurious and should never be used. 

Bleaching the Hair. — The woman who yields to the desire for golden 
hair when Xature decreed another color, assumes a terrible burden of 
discomfort and anxiety. The difficulties of the bleach by the peroxide 
of hydrogen are a tremendous price to pay for an adornment that seldom 
deceives any one but the wearer. The roots of the hair, being rich in 
natural coloring matter, are always darker for an inch or two next to 
the head than the rest of the hair; and the tips of the hair are always 
much lighter, to say nothing of the variegated streaks of natural color 
which will persist in showing, even after a whole day has been spent on 
the operation of bleaching. Hair that has been bleached may be returned 
to its original color only by the use of a dye until it changes ; or one may 
heroically stop the use of the bleach and let the color return openly. The 
tips of the hair, however, will never resume the original color. They will 
always remain tow white, and must either be dyed or sacrificed by cutting. 
Apart from this, peroxide used alone, if chemically pure, will not injure 
either the constitution or texture of the hair. The great harm is done 
by the admixture of ammonia, which hairdressers sometimes use to hasten 
the process. 

Superfluous Hair. — Probably nothing entails so much mortification 
and suffering upon a sensitive woman as a growth of hair on the face and 
arms. As far as the face is concerned, there is only one certain method for 
the permanent removal of such a growth, and that is by the electric needle. 
Yet this method is slow, painful, and expensive. It is necessary that 
the needle be inserted into the root of the hair with accuracy and pre- 



74 THE MAINTENANCE OF HEALTH. 

cision in order to kill the hair at the root. Even by the most expert 
operators this is done only about ten times in a hundred. If he is not 
skilled, the face is likely to be further disfigured by scars and eruptions. 
If persevered in, with this ratio of failure of the hairs treated at a sitting, 
it will, after much suffering and great expense, prove successful. Those 
who cannot afford this method or who dare not face it, then turn to 
chemical hair removers known as depilatories. Many are on the market, 
and the most absurd claims are made as to their efficacy. But let it be 
said that there is not yet a single preparation discovered which will perma- 
nently remove the hair. Most of these preparations remove the growth 
temporarily ; it returns more luxuriantly and abundant than ever. Hair 
on the arms may be removed by the use of pumice stone. This wears 
the hair down to the surface of the skin so that it cannot be seen. Some 
resort to the heroic means of pulling the hairs out by the aid of tweezers. 
It is needless to say that in all of these cases the hair comes in again 
stronger than ever. 

CARE OF THE NAILS. 

Like the hair, the nails are regarded as modifications of the skin. 
Their uses are to protect the tips of the fingers, where the sense of touch 
is extremely delicate, and the toes; also to enable us to pick up small 
objects easily. The nail is inserted in a groove of the skin, known as 
the matrix, and is attached to the flesh by what is popularly known as 
the quick. The growth takes place from a multitude of cells at the root 
of the nail. The growth of the nail has been measured by making a mark 
at the base of the nail and then observing the length of time elapsing 
before the mark has moved or grown up to the tip or end. It has been 
found that the thumb nail grows from its root to the free end in five 
months ; the great toe nail in ten months. 

There are several marks which can be observed on the nails. Ridges 
running up and down the nail are caused by scraping the surface of the 
nail either with a knife or file. This practice causes an uneven growth 
or roughness on the surface in which dust accumulates and destroys 
the polish. The treatment for this condition is to stop the practice, and 
to polish the nails with the nailbrush. The same effect is also produced 
by the habit of scraping the inner surface of the tip of the nail with a 
knife or sharp steel tool when cleaning the nails. White spots or flecks 
on the nails are due to an interruption in the circulation of the blood 



MANICURING. 75 

under the nail, and often result from blows, scraping, or slight cuts of 
the nail surface. Heavy blows on the nails cause black and blue discolor- 
ation by escaping blood from the -ruptured blood vessels. The loss of the 
nail nearly always follows this condition. The moon-shaped, light-colored 
parts at the base of the nails are caused by a difference of the circulation 
of the blood at that part. These are regarded as elements of beauty in 
the nails and are to be preserved. Ridges sometimes run across the nails. 
These are caused by severe illness or periods of great weakness, during 
which time the growth of the nail is not so active as before and after the 
attack. One can tell, often, by these ridges that a person has had a severe 
illness, and by estimating the location of the ridges on the nail can form 
some idea of the date of it. This is one of the mysterious observings of 
palmistry. 

Hygiene of the nails requires that the tips or free ends of the nails 
be kept scrupulously clean. The accumulation of dirt under the nails, 
besides being uncleanly, is often of a poisonous nature; it is the direct 
cause of serious consequences when children pick a sore. This accumu- 
lation of material under the nails is also a common means of communi- 
cating disease. It is most conveniently removed just after washing the 
hands, and by using the nailbrush over the extremities of the fingers. 
The nail is nearly surrounded, except at the free extremities, by a pro- 
tective sheath, which should not be allowed to adhere to the nail, as it 
grows with, or is drawn along by, the growing nail. After a time it 
breaks or splits, forming the painful agnail, commonly called hangnail. 
This can be prevented by pushing the sheath back from the nail gently 
while the hands are still moist from washing. A sharp edge should 
never be used for this purpose ; the towel is much better. If these sheaths 
become ragged from neglect of this simple means, they may be snipped 
off with scissors to prevent more serious tearing. It is, perhaps, unnec- 
essary to say that good breeding and a proper regard for the comfort of 
others require that all of this attention to the nails is to be performed 
in private with the rest of one's toilet. 

Manicuring. — The proper and systematic care of the nail is known 
as manicuring. It is an act which any and all can perform, as it is 
extremely simple. Professional manicurists surround themselves with 
almost as many tools as a dentist. But these are not at all necessary. A 
satisfactory and complete outfit is extremely simple and inexpensive. 

1. Nippers for cutting the nails are much more convenient and 
effective for personal use than are either curved or straight scissors, or 





~: THE MAINTENANCE OF HEALTH. 

a knife. In fact a knife should never be used for treating the nails; 
for, while there are a very few little attentions which it can give well 
:; :he rails rhere is su:h rrea: :err::ar:r :: r:ake inrrrre: arc inju- 
rious use of it. 

2. A nle for smooth- 

ir.g- iv. i sharirr the eires 

of the nails after cutting 

with the nippers. It should 

Nau. Nippers. ** of me finely cut variety 

known as the velvet file. 
J. A bur. lie :: zrarrre ~rz>:-i sticks ::: :learir.r :he exrre:ri:ies 
::r rushirz; ":a:k :he shear: :r:r: rhe base arb sibes :: rhe rails 

4. A piece of chamois leather or a buff er for polishing the nails. 

5. A box of rose-cokir^ ;b ;as:e. 

6. A box of nail powder. 

7. A piece of pumice to remove spots or roughness. 

8. A jar of Amandine. 

With this equipment anyone may keep the nails in excellent condition 
by the expenditure of a little time and trouble. The regular operation of 
manicuring need not be performed oftener than once a week. 

The tips of the fingers of one hand at a time are covered lightly with 
Amandine. This is a preparation of gum arabic. honey, almond cream, 
almond oil, and perfumed with bitter almonds or attar of roses. It is 
too difficult to be made borne, and r a be bought ready prepared. 
The white variety is :vt purer. The effect of Amandine is cleansing 
s :::tr ::r arb heakrg\ The harb is r:er s:akei ::r several rrirures ir 
warm water, after which it is to be carefully dried. Xext. the sheath 
around the nails is gently pressed back from the naiL This may 
be done, if it is free, with a towel or soft napkin. If it adheres in the 
rail use rhe :rarre : : : s:i:k :: free i: :u: re e: use :-. l-r:i:e :: a i:t:^ 
instrument. The nails are then cut with the nippers. The object to be 
sought in cutting is to secure a perfectly oval form, and to have the nails 
as nearly as possible all of the same shape. This may take time to effect 
by reasrr :f previous bai habits. Tbt i::uurula:i ::: :: rarer :,: r;e :ir 5 
of the nails is to be removed by means of the orange wood stick. Xever 
use knife or steel in doing this work. The orange wood stick is whittled 
to a flat chisel-like point for this purpose. The soft file is then used on 
the edges of the tips of the nails to give smoothness and evenness to 
the edge. Remove roughness and ink spots with pumice stone. Dis- 



CARE OF THE NAILS. 77 

colorations of the nails may be removed by the use of a little vinegar 
or lemon juice. 

A little rose paste is then placed upon the nail surface. It is made 
as follows : — 

Rose Paste for the Nails. 

Spermaceti, iy 2 ounces. 

White Wax, 9 drams. 

Oil of Almonds, 12 ounces. 

Alkanet Root, 2 ounces. 

Attar of Roses, 1 dram. 

The first four ingredients are melted together and strained; beaten 
well until nearly cold; and the attar of roses is then added. 

A fairly thick coating of powder is then dusted over the paste and 
the nails are polished with the chamois skin or the buffer. The rubbing 
or polishing is always to be across the nail, never /up and down. The 
nail powder is made as follows : — 

Powder for Polishing the Nails. 

Silicon, 8 ounces. 

Oxide of Zinc, 2 ounces. 

Pulverized Pumice, y 2 ounce. 

Rose coloring matter. 

These are ground fine in a mortar and passed through a very fine 
sieve. 

The preparations which are given may all be procured ready com- 
pounded at drug and department stores. Homemade remedies, while 
they are guarantees of the purity of the preparations, are usually difficult 
to manufacture. 

During the rest of the week, vigorous scrubbing with the nailbrush 
and careful pressing back of the sheath around the nail is all the care 
required to keep the nails in good order, with, of course, regular daily 
cleansing of the extremities with the orange wood stick. 



CARE OF THE ORGANS OF RESPIRATION 
AND OF THE VOICE. 

Protection Against Cold. — The effects of cold are, perhaps, most 
commonly and severely felt in the organs of respiration and of the voice. 
They are : the larynx, the trachea, and the lungs. These organs require 



78 THE MAINTENANCE OF HEALTH. 

constant and watchful care and protection against cold. The principal 
and best methods of protection are : frequent bathing of the chest and 
throat in cold water and subsequent vigorous rubbing; and by proper 
clothing. For those who are susceptible to cold in these organs, more 
than ordinary warmth of clothing is required. A woolen undervest or 
chamois jacket, or a few folds of newspaper, are effective means of pro- 
tection against cold and winds, especially when driving. But such pro- 
tection must not be worn one day and discarded the next. With some 
persons it is customary, after a fever square or mustard plaster has been 
applied to the chest, to wear for a time a protective covering of cotton 
wool upon which a little dry mustard has been sprinkled. Great care 
must be observed in leaving this off; and equally great care be taken 
that it is not worn too long. For these protective coverings owe their 
efficacy to the fact that they are nearly impervious to air, and, conse- 
quently, do not allow the emanations of the body to pass off freely. 

Cold in these parts manifests itself, as in other parts, by inflamma- 
tion, more copious secretions, and in efforts to allay irritation or to 
expel accumulated secretions by coughing. The condition of inflamma- 
tion and the part affected are usually indicated in the name of the disease, 
by attaching the termination "itis" to the name of the part or organ 
so affected. Laryngitis is inflammation of the larynx; tracheitis is 
inflammation of the trachea; and so on. All of these diseases are dealt 
with in detail elsewhere. It is here desired to make clear the care that 
must be taken to avoid cold, chills, draughts, and exposure, which are 
certain to bring these diseases on. 

Vocal Cords. — As the vocal cords are situated in the larynx, affec- 
tions of these parts are generally accompanied by hoarseness or partial 
loss of voice. There is a form of inflammation of the larynx, which is 
caused by long, loud, and continued speaking. It is known sometimes 
as "Clergyman's Sore Throat." The vocal cords are not cords at all, 
but thin, delicate, muscular membranes stretched across the glottis. 
When they are used too long, or too vigorously, they become inflamed 
and cause pain and irritation of the throat. They are more in repose in 
speaking than in singing ; and more in repose when there is slight modu- 
lation of the voice than when there is considerable range to the speaker's 
tone. 

It is a great art, and one which all speakers and singers should strive 
to cultivate, to save the voice as much as possible. It is said that the 
admirable art of reading aloud pleasantly, easily, and for a length of 



CARE OF THE LUNGS. 79 

time, is passing away. The cultivation of the pure tone in reading and 
the habit of reading aloud for an hour at a time is a splendid vocal and 
throat exercise, if it is done properly. A pleasant speaking voice is a 
desirable possession ; and it is something that every one may gain by 
proper practice and training. The cultivation of the voice is not con- 
fined to speakers and singers, but should be striven for by all, as one 
of the requisites of a good conversationalist. 

Nose Breathing. — One great protection against cold and other affec- 
tions of the throat and lungs is properly conducted nose breathing. Espe- 
cially is this true in winter cold and in damp weather. The habit of 
taking the cold air through the mouth and into the throat and lungs 
without the slight but necessary warming that it gets in passing over 
the surface of the inner nose, is responsible for much disease. 

Dangerous Occupations. — There are many occupations in which 
the workmen who carry on the several processes are obliged to inhale 
poisonous and injurious matter. The dust of coal mines; the particles 
in iron, lead, tin, and copper mines ; the clay particles in pottery making ; 
the dust from steel in grinding and polishing; the poisonous gases, and 
vapors in chemical works and paper mills ; the fire damp of mines ; the 
chlorine and sulphur fumes in bleaching mills; the carbon bisulphide in 
rubber works ; and the phosphorus in match factories, all exert a poison- 
ous and injurious effect upon the workmen, despite the best preventive 
efforts and sanitary methods. All the forms of throat and lung trouble 
result from these occupations, and they materially shorten the lives of 
those engaged in them. 

Cold Water Application. — The method of taking the cold water 
applications recommended to those who have delicate throats and lungs, 
and who are susceptible to cold in these organs, is not by gentle applica- 
tions with a cloth or sponge, as in a sponge bath. More vigorous treat- 
ment than that is required. One must strip to the waist and splash the 
cold water repeatedly upon the chest and throat — at least a dozen times, 
more if it can be borne, — and follow it quickly by a vigorous rubbing with 
a coarse towel. It is a nerve treatment, and the involuntary gasp that 
is evoked by the splashed water is proof of both its efficacy and need. 
The glow and the after effects will abundantly compensate for the momen- 
tary discomfort. If cold water cannot be borne at first, let the taking 
of it be a matter of education, and begin with water as cold as can be 
borne, and gradually reduce the temperature of it. It is recognized by 
all medical authorities as the most effective means of invigorating the 



8o 



THE MAINTENANCE OF HEALTH. 



parts and of rendering one able to withstand the cold and rigors of a 
northern climate. It is an infinitely better and safer treatment than the 
habit of burdening the throat and neck with wrappings. 

Bad Sitting Position. — Incorrect habits of sitting are both a means 
of producing bad effects upon the organs of respiration and also an indi- 





Fig. 10. Correct Sitting Position. 



Fig. 



Incorrect Sitting Position. 

cation of weakness in these organs. Any position of body which does 
not allow free play to the lungs and the unrestricted ingress and egress 
of sufficient quantities of air into them, is at once characterized as a 
bad one and should be corrected as speedily as possible. The outward 
signs of weakness and the effects of bad position are stooped shoulders, 





Fig. 12. Desk Too High. Fig. 13. Desk Too Low. 

fiat or hollow chest and listless movements. Bending over the work at 
desk or table is the most prolific cause of these ; and the results are more 
pronounced when the subject is afflicted with near-sightedness, which 
necessitates a more cramped position. One of the first points to which 



CORRECT POSTURE. 81 

attention should be directed is the proper height of the chair. It must 
not be too long in the legs, as that causes the sitter to keep the feet 
dangling a few inches from the floor, which interferes with the circula- 
tion or compels him to sit on the front edge of the chair in the effort 
to have the feet rest upon the floor. This latter position throws the 
upper part of the body forward over the desk or table. Where high 
stools are used, there must be an adequate and properly adjusted foot 
rest. There must also be a properly proportioned height of both chair 
and desk or table to insure comfort. If the desk is too low, the subject 
is sure to bend over; if the desk is too high, the work is brought too 
close to the eyes. Little children ought to be supplied not only with a 
high chair, but also with a small chair and a low table adapted to their 
size. This inexpensive recognition of their needs will go far towards 
preventing the evils of flat chests and round shoulders. The habit of 
crossing the legs while sitting is injurious, as it interferes w T ith the circu- 
lation, even to the extent of putting the foot "to sleep." Sometimes the 
sharp edge of a chair presses too tightly upon the blood vessels of the legs 
and stops the circulation. 

Bad Sleeping Position. — An unhealthy and injurious position in 
bed is the result of using too many pillows. For those whose chest 
development is not all that is to be desired, or for those who are flat- 
chested or round-shouldered, one small, flat pillow is sufficient. The 
pillow may properly be as thick as the distance from the neck to the out- 
side point of the shoulder, which is sufficient to keep the head in the 
proper position when a person lies on the side. Lying propped up with 
several pillows after a day spent over a desk or table is certain to be the 
cause of the defects mentioned. Such a pillow as suggested and a not 
uncomfortably hard bed will insure a proper position or body for at least 
eight hours out of the twenty-four. 

Correct Standing Position. — To insure a correct standing position 
that in use in the army may well be followed, for it is the result of years 
of experience and the survival of the fittest of all suggestions. 

Stand squarely on both feet, heels in line, toes turned out, legs 
straight, hips slightly drawn in, body erect, chest expanded, shoulders 
square, head erect, chin slightly drawn in, and eyes looking straight to 
the front. The habit of taking this correct position and of maintaining 
it for several minutes at frequent intervals during the day will prove 
very beneficial. In order that one may realize how far one's ordinary, 
customary carriage deviates from this ideal, it is a good plan to stand 



82 



THE MAINTENANCE OF HEALTH. 



with the back against the wall or a door and align the body with it by 
forcing back the shoulders and head so as to touch it in all possible 

parts of the back of the 
body, and then allow the 
body to relapse into the cus- 
tomary attitude. The per- 
ceptible difference of posi- 
tion will guide one as to one's 
need of this exercise. The 
bad fit of clothing at the 
neck and shoulders is often 
caused by the unconscious 
assumption of a more than 
usual erect position of body 
at the time of fitting, and the 
subsequent relapse into the 
habitual position. 

Flat Chests and Round 
Shoulders. — For flat chests 
and round shoulders, the breathing exercise is an invaluable means of 
improvement. It is capable of many variations and modifications which, 
regularly performed, will undoubtedly be of great benefit. 





Fig. 14. 

Correct Standing 

Position. 



Fig. 15. 

Incorrect Standing 

Position. 



Exercise No. i. 

Stand erect, exhale deeply, 
bring the arms out straight in 
front of the body at full length, 
the palms touching. Slowly 
inhale as deeply as possible, and 
at the same time gradually 
bring the arms, with a per- 
fectly horizontal sweep, out at 
right angles to the side of the 
body, and as far back as pos- 
sible, at the same time rising 
upon the toes. 

Maintain this position for a 
moment. Then slowly exhale as deeply as possible and bring the arms 
back gradually to the former position in front of the body, and sink to 
the flat of the foot again. 




Fig. 16. 
Position i. 



Fig. 17. 
Position 2. 



EXERCISES TO CORRECT DEFORMITIES. 



83 



Light wooden dumb-bells, not exceeding a half pound in weight, may 
be used to advantage in this exercise. (See Figs. 16 and 17.) 



Exercise No. 2. 

Drop the arms to the sides at full length. Exhale deeply. 
Slowly raise the arms at full length above the head, palms 
touching, at the same time taking a full, deep breath, and 
raise the body upon the toes. 

Maintain the position for a moment. Then slowly exhale 
as deeply as possible, let the arms fall back to the former 
position at the sides, at the same time exhaling deeply, and 
sink to the flat of the foot again. 

Dumb-bells may be used to advantage in this exercise. 
Fig. 18. 

Exercise No. 3. 

Take a step forward with the right foot, slightly bend the 
right leg at the knee, keep the left leg straight. Bend the arms at the 
elbow and place the clenched fists on the chest. Exhale deeply and thrust 
out the arms alternately straight out to full extent, with as much force 
and in the same manner as in striking a punching bag. Inhale deeply 
and slowly. 

Reverse the position by throwing forward the left leg and repeat as 
before. Figs. 19 and 20. 

Dumb-bells may be used to advantage in this exercise. 

Exercise No. 4. 
With dumb-bells. Let the dumb-bells rest lightly 
upon the shoulders. Bend the arms with the elbows close 
to the sides. The arms are then thrown out straight in 
front of the body. These movements may be performed 
both simultaneously and alternately. Fig. 21. 

Exercise No. 5. 

With or without dumb-bells. Place the hands on the 
chest. Arms bent at the elbows. Exhale deeply. Throw 
the arms backwards at full length and inhale deeply. 

The effect of this movement is the forcible expansion of the chest. 




Fig. 19. 
Position 



8 4 



THE MAINTENANCE OF HEALTH. 




Fig. 20. 
Position 2. 



Exercise No. 6. 
With dumb-bells. Let the dumb-bells rest lightly upon the shoulders. 

Arms bent and upper arm at right angles to the body. Alternately 
extend the hands as high as possible with a reaching 
motion above the head. Exhale and inhale deeply and 
slowly. Fig. 22. 

Practise all of these exercises moderately at first; 
gently increase both speed and length of time as fast 
as it can be borne. Perform with loose clothing in a 
well ventilated room, preferably on rising and before 
retiring. Several of the exercises are to be taken at 
one practice to vary the monotony. Two or three 
months of faithful practice will work wonders in devel- 
oping a full chest, and in straight- 
ening the shoulders. Keep up the 
splash bath of cold water upon the 
chest and follow it with vigorous 

rubbing. Let the bath precede the practice rather than 

follow it. If you are wearied or fatigued with work 

or other exercise, do not take your practice. Never 

take it just after eating. 

For the rest of the day make up your mind that cer- 
tain and positive means must be 
taken to remedy these defects. The 
will power must be exercised to break 
the bad habits, and the exercises 
which are taken must be faithfully followed up. It is 
comparatively easy to correct the faults and to incul- 
cate good habits and an erect carriage in young people ; 
this can also be very successfully conducted in the case 
of middle-aged persons; and even old persons need 
not despair. But forgetfulness, inattention, and irreg- 
ular practice of the exercises will not do. Persistence 
and determination are required, and beneficial results 
are sure to accrue. 

Running and skipping the rope are also excellent 
exercises for developing the chest in the case of young 

people who are flat-chested. But both exercises must be practised in 

moderation. 





Fig. 21. 
Position 2. 



Fig. 22. 
Position 



AIR AND VENTILATION. 85 

Singing and voice culture are strongly recommended in all cases of 
weak organs of respiration. Much care must be taken, however, in the 
case of young girls about the age of fourteen. With them it is a very 
easy matter to overdo and to defeat the very object for which these exer- 
cises are prescribed. 

IMPORTANCE OF FRESH AIR AND VENTI- 
LATION. 

As it has been said that a man can live three weeks without food, 
three days without water, and three minutes without air, it seems fitting 
that a consideration of the laws of healthy living should deal fully with 
the subject of air as being most essential and important. 

The active, life-giving constituent of the air is oxygen gas, which 
forms about one-fifth of the volume of the atmosphere. It is this oxygen 
in the air which, in the process of breathing, is taken into the lungs and 
there purifies the blood. The other constituents of the air are nitrogen 
gas, which forms nearly all of the remaining four-fifths of the volume 
of the air and is an inactive, harmless gas ; and several gaseous and solid 
impurities which are present in only very small proportions. Among 
these impurities are : — 

Ammonia gas and its compounds, which are given of! from the decay 
of animal and vegetable matter. 

Carbon compounds, especially carbonic acid gas or carbon dioxide, 
which are given off during the breathing of man and other animals ; by 
the burning of coal, wood, and gas; and by the decay of animal and 
vegetable matter. 

Sulphur compounds, from the decay of animal and vegetable matter, 
and the burning of gas. 

Dust, mineral, animal, and vegetable particles, which may be seen 
floating in a ray of sunlight. 

Bacteria, which are living forms of animals, microscopic in size, and 
present in the air in all localities. The purest air and the freest from 
bacteria is found in mid-ocean, and at the highest elevations. 

The impurities found in buildings and crowded localities are : — 

1. Impurities from breathing. 

2. Impurities from perspiration. 

3. Impurities from burning coal, wood, and gas. 

4. Impurities from the walls, floors, ceilings, and ■ furniture. 



86 THE MAINTENANCE OF HEALTH. 

Diseases Caused by Impurities in the Air. — Smallpox, measles, 
chicken pox, German measles, typhus fever, influenza, whooping cough, 
and mumps are undoubtedly spread by infective particles floating in the 
air and clinging to the walls and furniture of houses, as well as to the 
clothing of the occupants. Scarlet fever and diphtheria are generally 
so spread. Enteric fever, cholera, diarrhcea, dysentery, and yellow fever 
may be communicated in this way; and cerebro-spinal meningitis is 
apparently so spread. Hay fever is caused by inhaling pollen dust in 
the air. Bronchitis, pneumonia, phthisis, and asthma are caused some- 
times by irritant gases and solid particles in the air. Sore throat, ton- 
silitis, and some forms of colic, may be contracted from more or less 
severe poisonous impurities. 

Effects of Some Impurities in the Air. — Carbon dioxide, or car- 
bonic acid gas, when breathed in full strength, kills instantly by a spasm 
or contraction of the glottis. When present in the proportion of only 
thirty parts in 1,000 parts of air, it produces slowness and feebleness of 
the heart's action and great difficulty in breathing ; and fifteen parts have 
produced severe headache. It is breathed out during respiration and is 
the chief impurity in overcrowded and poorly ventilated buildings. As 
it is much heavier than ordinary air, it accumulates in old wells, cellars, 
mines, and other low places. When present in dangerous quantities, it 
may be detected by lowering a lighted candle into suspected places, where 
three per cent of the gas will extinguish the flame. If limewater be 
exposed in a saucer in a room, a white scum will form upon the surface 
of the liquid if this gas be present even in very small quantities. 

Carbon monoxide is a more powerful poison than carbon dioxide. 
An extremely minute quantity causes headache, giddiness, and insensi- 
bility. This is the poisonous gas given off when the fumes of burning 
charcoal escape into a room, and it is thus, very frequently, the cause of 
death, both accidental and suicidal. 

Dust from mechanical and metallic trades and manufactures produces, 
when inhaled by the workmen, asthma, bronchitis, consumption, blood- 
spitting, and poisoning. 

Amount of Fresh Air Required. — It is estimated that an average 
adult consumes at each breath about thirty cubic inches of air. At the 
rate of seventeen breaths per minute, each adult will consume 425 cubic 
feet of air in each twenty-four hours. In order to insure getting rid 
of the used air, and of furnishing a sufficient supply of fresh air, it is 
necessary that an adult in repose have 3,000 cubic feet of fresh air every 



TESTS FOR THE PURITY OF AIR. 87 

hour; under moderate exertion, 4,500 cubic feet; and when engaged in 
hard work, 9,000 cubic feet per hour. As living rooms never approach 
a size of even 3,000 cubic feet, it follows that, in order to supply the 
needed amount, the air in an ordinary room must be changed several 
times in an hour, which number will depend upon the size of the room. 
In order, therefore, to ventilate properly, one must know the amount of 
air required by all of the inmates, and the space per head. Then one 
must know something of the quality and purity of the air that is to 
replace the foul air; for great care must be taken that it does not come 
from a contaminated source. Further, it must be admitted imperceptibly, 
so that a draught is not created. And especially must this care be taken 
when the temperature of the outer air is lower than that of the rooms. 
One of the hardest problems of ventilation is to see that the air does 
not merely come through a window and pass out by a door, but that the 
fresh supply is equally and fully distributed throughout the entire space. 

Testing the Purity of the Air. — Under ordinary circumstances, 
tests of the purity of the air must be made by the senses and not by 
exhaustive chemical analysis, except in special cases. To investigate 
the purity of air in a room, one should enter immediately from the outside 
fresh air. Careful note should be made of whether the inside air smells 
fresh and sweet, rather close, close, or very close. In damp weather the 
odors, if any, will be more pronounced than in fair, dry weather. The 
sense of smell will also detect the presence of organic matter, the escape 
of gas, leakage of sewer gas, dampness or mustiness, and the presence 
of dust. This is as far as an examination by the senses can go ; but it is 
far enough to tell whether the atmosphere of the house is conducive to 
health or not. A thorough examination will require a chemical, micro- 
scopical, and a biological investigation, by which means deleterious gases, 
dust, solid impurities, and bacteria may be certainly and accurately deter- 
mined. 

Effects of Breathing Bad Air. — If the air is extremely vitiated, as 
in the case of the famous Black Hole of Calcutta, or in overcrowded 
vessels with battened down hatches in stormy weather, death will result 
from the lack of oxygen and the presence of organic matter in the re- 
breathed air. In slighter vitiation, when foul air is breathed for a long 
time, the results are anaemia, weakness, depression of the vital forces, 
and interference with nutrition. Indirectly or directly, lung diseases 
develop in time; and headache, loss of energy and want of appetite are 
among the most marked results. So it follows that light and oxygen 



88 THE MAINTENANCE OF HEALTH. 

are the most powerful agents iri the eradication or the arrest of many 
such diseases as phthisis, typhoid, and other contagious diseases. 

The foul air of crowded theaters, churches, and assemblies, especially 
at night when much gas is burned, causes anaemia, headache, and even 
stomach derangement when the air is breathed for only a few hours. 

It is bad enough to breathe the air contaminated by the emanations 
from the lungs and bodies of healthy persons ; but the effects are intensi- 
fied and the danger increased when the impurities proceed from the 
bodies and the lungs of the sick and diseased. Not only is consumption 
spread in this way, and the other contagious diseases proper, but also 
erysipelas and gangrene. 

The air of sewers has been known to directly and instantly produce 
death by asphyxiation, sewer gas poisoning, and to develop fatal cases 
of pneumonia. In smaller quantity, sewer gas, when breathed, pro- 
duces lassitude, loss of appetite, vomiting, diarrhoea, prostration, and 
fever. Well authenticated instances have been recorded where food 
which had been impregnated by sewer gas was eaten with fatal poisoning 
results. 

Marshes, in which much decay of vegetable matter always takes 
place, give off poisonous gases, such as marsh gas. Residents of such 
localities are always subject to malarial diseases and even to acute fevers 
and dysentery. 

How to Ventilate. — Good ventilation requires that each occupant of 
a room shall have 600 cubic feet of space, and that the air in 
this space be changed five times every hour, so that he gets 3,000 cubic 
feet of fresh air during that time. It is a simple matter to estimate the 
number of occupants any room will accommodate comfortably. Multiply 
together in feet the length, breadth, and height of the room, and divide 
the product by 600. On this principle a sleeping room should be 1 1 feet 
long, 11 feet wide, and 10 feet high to accommodate two persons. Pro- 
vision must be made for changing the air in such a room five times every 
hour. And this makes no allowance for lights. A single light in a 
room will vitiate as much air in a given time as ten persons will, for 
the light uses up the oxygen from the air. This is not true of incan- 
descent electric lights, which use no oxygen. 

In ordinary cases, the easiest and best way to ventilate is to open 
the window a little at the top and bottom. This allows the warm, foul 
air of the room to pass out at the top, and the cooler, fresh air from 
outside to enter at the bottom, in obedience to the well known law of 



HOW TO VENTILATE. 89 

physics. In sleeping apartments, an additional supply of bedding can 
be used in cold weather to make sleeping comfortable in the lowered 
temperature caused by ventilating. 

The effect of slight openings at top and bottom of windows may be 
realized when it is known that a wind traveling at the rate of two miles 
an hour, which is barely, if at all, perceptible, will sweep across a room 
twenty feet wide with sufficient rapidity to change the air in that room 
548 times in an hour. There is always some air finding its way in and 
out of a room through the loose fitting window frames, by the opening 
and closing of doors, and through the chimneys. In houses heated by 
furnace, with cold air shafts communicating with the outer air, some 
also finds its way in by that means. But all of this ingress and egress of 
air is by no means sufficient. Regular and systematic methods of ven- 
tilation must be adopted in every home to so frequently change the air 
throughout the house that that within may be as pure as that outside, — 
which is the ideal ventilation. 

Those who are careful about the air they breathe are often commis- 
erated by others, or are ridiculed about their "hobby" by those who have 
never stopped to think of that stupendous, marvelous process which we 
are accustomed to speak so lighjtly of as "breathing." Let such persons 
carefully consider these facts : — 

1. Each human being takes at least seven million breaths a year. 

2. He inhales one hundred thousand cubic feel; of air annually. 

3. He purifies over three thousand five hundred tons of blood in 
that time. 

All of this is done without worry, weariness, or even conscious atten- 
tion on his part. 

How to Breathe Properly. — Respiration, or breathing, consists of 
two more or less unconscious or involuntary acts : inspiration, the taking 
of air into the lungs; and expiration, the act of breathing out. The 
fact that these acts require no attention on our part is the chief reason 
why they are not performed properly. The lungs, as previously stated, 
consist of a collection of six hundred million little air cells, or bladders, 
into which the air is drawn by inspiration. When little short, catchy 
breaths are taken, some of these cells in the deeper parts of the lungs 
are neither emptied of the used air nor filled with fresh air. It is only 
in the deep panting after violent exercise, in involuntary sighing, or, 
best of all, in the deep, deliberate, voluntary inhalations that all should 
practice every day, that they are brought into use. When we consider 



90 THE MAINTENANCE OF HEALTH. 

that most persons use only about one-half the full lung power, and at 
the same time fill that space with impure air, is it remarkable that so 
many suffer from the long train of impure blood diseases and an anaemic 
or bloodless condition? 

Children should be early taught to breathe through the nose and not 
through the mouth. If a child develops the habit of "mouth breathing" 
a physician should examine it for adenoid growths, which close up the 
back passages of the nose. The removal of these growths is a very simple 
surgical operation, and it is not only advisable but absolutely necessary 
to the health of the child that they be removed as early as possible. 
Nose breathing is the natural method, and to this end the nose is lined 
with hairs to catch particles of dust and to prevent them from entering 
the lungs. When cold air is breathed through the nose, it passes over 
a large surface, which warms it slightly before it enters the lungs. When 
very hot air is breathed, such as the air near furnaces of rolling mills 
and other factories, as well as that of hot, sandy deserts, it is slightly but 
sufficiently cooled by passing over the extensive surfaces of the nasal 
passages. It also passes over the surface covered by the nerve of smell, — 
the olfactory nerve, — by which bad odors, escaping gas, and other im- 
purities are detected in time to warn one of their presence. 

There is no better form of exercise for the development of the chest, 
and for the improvement of the general health, than the fixed habit of 
two or three times every day taking a number of deep breaths. This can 
be best done during a walk. Some begin by inhaling during four or five 
steps, and exhaling during the next four or five. In a very short time the 
act of inhaling or exhaling may be made to endure for six, seven, and 
even ten steps. By this simple exercise the chest muscles, and the inter- 
costal muscles between the ribs, are exercised; the diaphragm is pushed 
down and the abdominal muscles are brought into action ; the size and 
elasticity of the chest are increased ; the shoulders are raised and squared ; 
the lungs expand, and all of the six hundred million air cells are filled 
with fresh air and emptied of the impure air and the poisonous carbonic 
acid gas ; but, above all, the oxygen is brought into contact with the 
impure blood and freshens and revivifies it, so that it goes coursing, 
under the heart's action, through the body and limbs, carrying new life 
and vigor and health to every part. 

When one begins this exercise, the measurement of the chest should 
be taken at forced expiration, and again at forced inspiration. The 
difference of these measurements is called the mobility of the chest or 



CARE OF THE NOSE. 



9i 



the chest expansion. It is the measure of the chest capacity. 
Gymnasium records show that those whose mobility at the 
beginning of this exercise was barely one inch, have, by reg- 
ular practice, developed an expansion of three and even four 
inches and more. This breathing exercise may be taken in 
a well ventilated room with open windows, both on rising and 
before retiring, as well as during one's walks, with immense 
physical advantage. 

During the breathing exercise taken in the morning or 
at night before retiring, a beneficial modification may be 
adopted. With the hands at the sides, exhale as deeply as 
possible. On slowly inhaling raise the hands to the full ex- 
tent above the head, as in the illustration given. This form 
of exercise is to be repeated slowly ten times. 



C 



Fig. 23. 
Position 2. 



CARE OF THE NOSE. 

Cleanliness. — The first essential in the care of the nose is cleanliness, 
and this is one of the lessons which should be taught as early as possible 
to children. Many an hour of wakefulness or of restlessness is passed 
by reason of obstructions in the nose caused by children's inability to 
remove the natural secretions. These latter are more profuse during 
a cold in the head, and the difficulty of breathing is greatly augmented. 
If these accumulations are moistened with a little warm vaseline care- 
fully inserted into the nostril by means of a soft camel's-hair brush, and 
the bridge of the nose be rubbed with a little vaseline or camphorated 
oil on retiring, much of the inconvenience will be removed and the 
breathing be greatly assisted. It is necessary that the nasal passages 
be kept free and unobstructed at all times, but especially in the case of 
a child who has contracted the unhealthy and pernicious habit of mouth 
breathing, which, once developed, may persist during life. Then, on 
the score of cleanliness, the habit of using the handkerchief should be 
taught to children. Some parents, in following up this lesson, pin a 
handkerchief by one corner to the child's shoulder, where it is both out 
of the way and close at hand when needed. The frequent removal of 
the secretion by the handkerchief will prevent the substance from hard- 
ening and thus obstructing the passages; and will also prevent a child 
from contracting the offensive habit of picking the nose; although the 



92 THE MAINTENANCE OF HEALTH. 

itching of the nose in children is regarded as an indication or symptom 
of stomach irritation or of worms. 

Cold in the Head. — The most serious affection of the nose is cold 
in the head, which frequently develops into catarrh. The precautions 
to be taken against catarrh consist not so much, if at all, in the care 
of the nose, as in the care of the body and the prevention of exposure to 
draughts and dampness. Still, the manifestations of the disease center 
in this organ and the adjacent parts. The delicate mucous membrane 
of the nose and of its connections are very sensitive, and, being well 
supplied with blood vessels, is soon the seat of painful inflammation, and 
the natural secretions of the nose are very much increased thereby. This 
inflammation and the increased flow of the nasal secretion are to be 
regarded as the curative force of Nature upon the cold. 





Fig. 24. Deformity 
Caused by Mouth Breathing. 

Mouth Breathing. — Mouth breathing is usually developed in children 
by an obstruction of the nasal passages. The commonest of these in 
childhood are the adenoid growths. These spongy growths form at the 
back of the nasal passages and are easily reached through the mouth. 
Their removal is not attended by much pain or inconvenience. If a 
child display a tendency to mouth breathing, accompanied by a dullness 
of facial expression, he should be at once examined by a physician. 
Adenoid growths usually develop around the third or fourth year. 

Polypus of the Nose. — Another growth develops later in life in the 
nose, and it also obstructs the passages and causes mouth breathing in 
adults. It is called polypus, from two Greek words meaning many feet. 
It was erroneously believed to have many roots or branches. It is an 
enlargement of the mucous membrane, and is attached to it by a small 
stem like that of a mushroom or toadstool. Its removal is a very simple 



CARE OF THE NOSE. 93 

surgical operation, consisting of burning it out with caustic, just as a 
wart is treated. 

Hairs of the Nose. — The hairs of the nose are designed to keep out 
much of the dust and the solid impurities of the air. These hairs often 
grow so long as to cause them to protrude from the nostril. The habit 
of pulling them out by the roots is very dangerous and differs from 
pulling hairs out of the outer skin. The hairs of the nose grow from 
the delicate mucous membrane, and violence to this is attended with the 
great danger of setting up an inflammation, which may be the direct 
cause of exciting a malignant growth. The fact that the pulling out of 
the hairs from the nose is nearly always attended by a sneeze, or at least 
by a desire to sneeze, is a proof that Nature resents such treatment, and 
that the act is an irritating one. It is much better to cut the long hairs 
off, if they are annoying, as this is sufficient to remove the unsightly 
appearance. 

Blowing the Nose. — Medical experts are calling the attention of 
the public to the importance of performing the nose blowing operation 
in a scientific and hygienic manner. First one nostril and then the other 
should be blown without undue violence. 

Doctors state that the two nasal passages should never be closed at 
the same time. If they are obstructed, as in the case of a cold, the 
back of the throat is filled with compressed air, and this, together with 
the discharge and the microbes which it contains, may be driven through 
the eustachian tube into the middle ear and lead to serious results. 

A great authority on the subject used to forbid his patients to blow 
their noses when suffering from a cold; but this course is hardly one 
which will commend itself to those who are in the habit of catching 
colds. The best advice would seem to be that when it is necessary to 
blow the nose, the blowing should be done gently. 

Atomizers and Douches. — It is frequently necessary to administer 
washes or lotions to the deeper recesses of the nose. This may be done 
either by means of an atomizer, the tube being placed well up in the 
nostril, and the liquid sprayed into the nose, the patient meanwhile assist- 
ing the process by snuffing the liquid up or extending its range by strong 
nasal inhalations; or the nasal douche is used. In this application, the 
passage from the mouth to the nose is closed and the liquid impelled by 
some force flows in at one nostril and out at the other. Such applications 
and douches are of great value in cases of chronic catarrh. 

Foreign Substances in the Nose. — When foreign substances lodge 



94 THE MAINTENANCE OF HEALTH. 

in the nose and cannot be extricated by simple means, the services of 
a physician would better be procured. He will probably remove the 
object with a small flattish probe having a bent end. This he slips up 
the nostril past the object and draws it out. Beans and similar objects, 
which are likely to swell after lodgment, are difficult to remove. Some- 
times the object may be forcibly driven out by closing the free nostril 
and energetically forcing the breath out. 

CARE OF THE EAR. 

A. GOLTMAN, M.D. 

McGill Medical University ; L.R.CP.and L.R.C.S., Edinburgh; L.F.P., Glasgow ; Consulting Oculist, New York City. 

Cold in the Ear. — The ear is an organ of great complexity and of 
extreme delicacy. The most delicate parts of it are placed well within 
the skull, and are both abundantly protected and difficult of access. 

Under no conditions should cold water ever be allowed to enter the 
outer ear. Not only excruciating earaches but permanent deafness has 
resulted from sleet and snow beating against the exposed ear. When- 
ever water is permitted to reach the inner portion of the ear, it should be 
at least tepid. So, in sea bathing, it is a wise precaution to protect the 
ear, with pieces of cotton wool, against the entrance of cold sea water. 

Cold draughts are always to be avoided, as they are the most fruitful 
cause of earache, and may lead to inflammation of the ear, with accom- 
panying discharges and abscesses. Even the hair around this organ 
should not be allowed to remain wet after bathing lest a chill reach the 
delicate membranes of the ear. 

Wax of the Ear. — The ear secretes a peculiar wax, which, so long 
as the secretion is normal in quantity, and is not increased by inflamma- 
tion, is Nature's own way of cleaning the inner tube of the outer ear. 
The only assistance expected from us in the way of cleansing the ear 
is to keep the outer shell of the ear and the entrance into the ear tube 
clean. This wax in the ear, when Nature is ready to dispense with it, 
peels off in tiny flakes, which, on dropping off, leave the tube perfectly 
clean. Attempts to clean the tube of the ear by such means as the corner 
of a towel or cloth screwed up and pushed into the ear, are only a cause 
of irritation and inflammation, and of an increased and abnormal supply 
of wax to be secreted. These attempts also serve to solidify the wax 
and to cause it to press unduly against the drum of the ear, with painful 
and dangerous results. 

Cold in the head, inflammation in the throat, and of the ear tube, 
also cause an increased secretion of wax in the ear. The inflammation 



WAX IN THE EAR. 95 

of the throat, caused by the inhalation of smoke by cigarette smokers, 
also produces similar effects. When this inflammation of the ear tube 
takes place, it causes a tickling in the ear, and one of the first sought-for 
means of relief is a pin, hairpin, match, pencil, or similar article which 
will remove the wax and thus stop the uncomfortable sensation. All of 
these means are attended by very great danger; for there is not only a 
certainty of hardening and solidifying the wax in the ear, but very great 
danger of injuring or even breaking the drum of the ear, which is a 
very thin and delicate membrane stretched tightly across the tube. The 
hardening of the wax is one of the chief causes of temporary or partial 
deafness. The wax should never be removed; the proper treatment 
consists in stopping the cause of the inflammation in the ear tube that 
excites the secretion of the abnormal amount of wax. Relieve the cold ; 
cure the inflammation in the throat ; stop the smoking ; but do not remove 
the wax from the ear. 

Hardened Wax in the Ear. — When from any improper treatment 
of the ear, or from disease, the wax has hardened so that Nature cannot 
remove it in her own way, it is to be softened by washing with warm 
water and castile soap applied with a syringe. When thoroughly dried, 
a few drops of good oil are to be poured into the ear. With this assist- 
ance it will be removed in a short time by natural means. This hard- 
ened wax in the ear produces difficulty in hearing. 

Noises in the Ear. — Colds are responsible for partial deafness, and 
also for some of the noises in the ear. The circulation of the blood under 
abnormal or diseased conditions produces many of the sounds and ring- 
ing in the ears. Some medicines, such as quinine, cause a roaring in 
the ears. 

There is a curious connection of the inner ear with the mouth by 
means of the eustachian tube, which opens into the upper part of the 
throat. Its office is to equalize the air pressure on the drum of the ear. 
In inflammation of the throat, this tube becomes involved and communi- 
cates the disturbance to the ear ; this is another cause of noises in the ear. 
But the familiar ringing in the ears is caused by interruptions in the 
circulation of the blood. 

Deafness in Children. — Many young persons are suspected of mental 
dullness, when the real trouble is partial deafness. They seem bright 
enough when anticipating a word or some direction, but when taken 
unawares they do not respond quickly. It is only right that, before 
such are regarded as mentally deficient, they be subjected to careful tests 



96 THE MAINTENANCE OF HEALTH. 

of both ears. It will be found, in many cases, that the hearing of one 
or of both ears is impaired. 

The sequelae., or after effects, of scarlatina, measles, and scarlet fever, 
often cause deafness or some affection of the ear. 

Boxing a Child's Ear. — Permanent and serious injury has fre- 
quently resulted from the criminal habit of boxing a child's ears. In 
some cases the drum of the ear has been ruptured, causing permanent 
and total deafness : abscesses have been induced, with running at the ears, 
which have caused the destruction of the drum of the ear : and fatal results 
have sometimes followed this brutally careless punishment. When there 
are so many other effective forms of punishment offered to those who 
believe in that sort of discipline, it positively assumes the magnitude of 
a criminal act to adopt so dangerous a means. 

Foreign Bodies in the Ear. — Foreign substances that become lodged 
in the ear usually require the attention of the physician. Attempts at 
removal by inexperienced persons who are not well acquainted with the 
anatomy of the part are very likely to produce serious effects. 

Sometimes insects enter the tube of the ear and cause extreme fright 
and alarm, even to the extent of convulsions in young children. The 
insect should first be killed by pouring into the ear about a teaspoonful 
of warm oil ; and it may then be washed or floated out by tepid or warm 
water. 

Tests of Hearing. — The sense of hearing is one of the latest senses 
to be developed in infants. This tardy development often occasions 
unnecessary alarm on the part of parents. Preyer says that if at the 
age of four months a child does not turn the head in attention when a 
loud noise is made behind its back, such as clapping the hands, or by 
speaking in a louder tone than usual, justifiable fears for the child's 
hearing may be entertained. Lack of response or of attention on the 
part of an older child when it is spoken to is not always caused by 
defective hearing. It may arise from concentration of attention or from 
absorption in work or play. This is a power that will prove too valuable 
in after life to warrant any attempts in the way of distraction. But 
where fears or suspicions of impaired powers of hearing appear to be 
well founded, a few very simple tests will soon decide the question. A few 
words or sentences spoken at a fair distance in a moderate tone, at a 
time when the child is not expecting them, may reveal the existence of the 
defect. When a person is expecting to be called or spoken to. or when 
his attention is fixed upon the face of the speaker, he is often enabled to 



TEST FOR HEARING. 97 

anticipate the speech, and the test will fail. The ringing of a distant 
bell, or the playing of music in another part of the house, may be made 
use of to test in some measure the imperfection of the sense. But in 
all tests, care must be taken that an absence of attention be not mistaken 
for defective hearing. 

The human voice is the best and most practical of all the tests of 
hearing, for that sense is most used in interpreting voice sounds. The 
tests should be conducted by both full voice and by whispers. If. how- 
ever, the space in which the tests are made is limited, whispered words 
and sentences are to be used. Distances should be marked off on the 
floor so that a fairly accurate note may be made of the distance at which 
sounds are heard by the patient. The subject is placed in a chair at 
one end of the room or hall, and is directed to keep his eyes closed during 
the tests. He is instructed to repeat such words and sentences as are 
audible to him immediately upon hearing them. The person conducting 
the test is to preserve the same degree of loudness during the test at each 
repetition of the word. He advances slowly toward the subject, repeat- 
ing the word or sentence selected, until he comes within the range of 
hearing. It is to be remembered in applying the test that some words, 
because of the preponderance of vowel and consonant sounds, are more 
audible at a certain fixed distance than are others. So that when the 
subject has heard one word at a distance of, say 25 feet, it does not 
hold that all subsequent tests must be made at the same distance. The 
person conducting the tests is to return to the former distance and select 
another word — the numerals are very good for this purpose — and note 
the distance at which each particular word is heard. Faithful records 
must be kept in order to observe, at another time, any improvement of 
the hearing power. 

The normal ear hears a whisper at a distance of from 10 to 40 feet; 
the names of the numerals are heard at from 8 to 40 feet. 

The ticking of a watch may also be used as a test, the subject being 
directed to raise his hand as soon as he hears the sound. There is no 
fixed distance at which a watch may be heard, as the sound varies so 
much in different watches. The same watch, however, must be used 
in subsequent tests in order to make a comparison at different periods 
of any value. 

There are many other methods of testing, such as using a series of 
tuning forks of different pitch; as some persons hear high-pitched tones 
better than lower ones. AYhistles, and an instrument known as the 



98 THE MAINTENANCE OF HEALTH. 

acoumeter, are used, but chiefly to assist the specialist in locating the 
cause of partial deafness. Rods, held in contact with the bones of the 
skull in the vicinity of the mastoid process, are also used for the same 
purpose. But their use and the deductions made from such tests are 
technical. By the voice and watch tests any person may easily learn 
whether the services of an aurist are required in any case of impaired 
hearing. 

Helps to Hearing. — The mechanical aids to hearing are chiefly of 
two kinds : the ear trumpet, and the artificial eardrum. The former is 
a horn-like contrivance, which serves to collect the sound waves and to 
present them to the eardrum with greater directness, force, and con- 
centration. The collection of the sound waves is the office of the enlarged 
cartilage, commonly called the shell of the ear. From its shape and 
position, it collects the air waves, upon which the transmission of all 
sounds depends, and causes them to enter the orifice of the ear, where 
they strike upon the tympanum or eardrum. "When this organ is ordi- 
narily sensitive, the hearing is good. Not infrequently, persons whose 
hearing is defective, are seen to place the hand behind the ear in the 
form of a shell in order to catch more of the sound waves, and thus to 




Fig. 25. Fig. 26. 

Ear Trumpet. Ear Tube. 

improve the hearing. The ear trumpet is only a modification of this 
service, and, where any degree of vibratory power exists in the eardrum, 
is an efficient aid. Artificial eardrums aim to provide a vibratory 
membrane as an aid to an impaired natural one. They are not always 
as efficacious as they are claimed to be. Further aids to hearing have 
taken the form of telephones placed in the rear chairs in churches and 
assembly rooms, whereby those who, either from defective hearing or 
from a too remote location, are precluded from hearing the speaker, are 
materially benefited. These telephones are connected with a sounding 
board or with receivers close to the speaker. As yet the microphone, 
designed to intensify very low or inaudible sounds, such as the walking 
of a fly, has not been adapted to the relief of the afflicted. The mega- 



CARE OF THE EYES. 99 

phone and speaking trumpet, inasmuch as they intensify sounds and 
supply some control by the speaker over the direction of the sound waves, 
also serve to make sounds audible. 



CARE OF THE EYES. 

If one has passed middle age without trouble with the eyes, or with- 
out impaired vision and the necessity of wearing eyeglasses or spectacles, 
one is tolerably safe. But when one considers the great army of spec- 
tacled school children and young persons, one feels that they are not 
so much the victims of faulty school conditions as of the carelessness 
of their parents and ancestors, and pity is evoked for the handicapping 
legacy which they have inherited. 

Children's Eyes. — It is one of the first duties of parents and teachers 
of young children to ascertain whether or not a child is suffering from 
any impairment of sight, or from a weak condition of the eyes. Where 
such exists, it is the duty of the parent and the teacher to see that such 
a child is placed in a good position in the schoolroom so that it can see 
the blackboards easily, and share in the school exercises with comfort 
and convenience. Many a child has unjustly been considered stupid or 
of slow mental development when the trouble consisted of some form of 
poor sight, which, from a back seat, prevented the child from clearly 
seeing the lesson on the board, or the teacher. We all know how intently 
we observe a person in whose conversation we are interested or whose 
discourse we are trying to follow. The removal of such a child to a 
more advantageous position has often resulted in rapid school progress. 

Need of an Oculist. — Where eye or sight trouble is suspected in 
either a child or an adult, no time should be lost in consulting a good 
oculist or optician. He will make a thorough and reliable examination, 
and will prescribe the proper treatment or the sort of glasses the patient 
should wear. To such perfection and reliability has this art been brought 
that good and trustworthy service is within reach of all. Irreparable 
injury has resulted from the haphazard choice of glasses and spectacles, 
and from the purchase of such from irresponsible persons. Blindness, 
even in degree, is such a serious deprivation that instant and proper care 
must be exercised to save the sight as much as possible. 

Defects of Vision. — It must be remembered that the eye does not 
see. It is the organ by which the rays of light are received, and an 



ioo THE MAINTENANCE OF HEALTH. 

image of the object or objects within the range of vision is received upon 
the black curtain (the retina) at the back of the eye. This sensation is 
communicated to the brain by the optic nerve. The cognizance of that 
image by the brain is what we call sight. Now, the perfection of sight 
depends very largely upon how that image is received upon the retina. 
If the rays of light from the object focus exactly upon the retina, the 
sight is good; it is normal. That condition of exact focus is called by 
opticians, emmetropia, and such an eye is said to be emmetropic. If 
the rays of light do not exactly focus on the retina, the condition is called 
ametropia; and it is with this condition that we are concerned in trying 
to understand defects of vision. Emmetropia does not much concern 
us, because that is the normal condition of the eye. But the condition 
of ametropia is the irregular condition upon which three common defects 
of sight depend. If the rays of light from an object do not focus exactly 
upon the retina, but fall upon it in such a way as to focus at some point 
behind it, if they focus at all, the condition of far-sightedness, or of 
hyperopia, as the optician calls it, results. The effect of this condition 
is that the image, instead of being clear and distinct as it is in the emme- 
tropic eye, is blurred and indistinct. The person sees well the distant 
objects but cannot see those distinctly which are close at hand. The 
optician prescribes for this condition a double convex lens, that is, one 
which bulges on both sides. As the rays of light pass through this they 
are brought to a focus at a point on the retina instead of behind it. 

When the rays of light, instead of focusing on the retina, as in the 
emmetropic eye, or focusing at a point behind it, as in the hyperopic eye, 
focus at a point a little distance in front of the retina, the condition is 
one of near-sightedness, or of myopia, as the optician calls it. The result 
of this is that the person is near-sighted. The optician corrects this con- 
dition by prescribing a double concave lens, that is, one which is hollowed 
out on both sides. This causes the rays of light which pass through the 
lens to come to a focus farther back than when they pass through the 
unaided eye. So the rays are made to focus on the retina instead of in 
front of it, and a clear image results. 

There is a third condition which is in some respects a com- 
bination of two of the conditions already mentioned. It is a con- 
dition where some of the rays of light received by the eye from 
an object focus exactly on the retina and others do not. That 
condition is known as simple astigmatism. Or some of the rays 
may focus behind the retina and others in front of it, when the condition 



ASTIGMATISM. 



101 



is known as mixed astigmatism. The effect of this .condition is a blurred 
image instead of a distinct one. The optician corrects this condition by 
prescribing a lens which bulges out on the side nearest to the eye and is 



straight up and down on the outer side, 
defect of vision, and may exist in 
only one eye without a person being 
conscious of it until it has advanced 
to a serious stage. The illustration 
here given is a form of astigmatic 
chart. It consists of a number of 
parallel lines radiating from a cen- 
ter. On looking at these lines, one 
eye at a time, if the sight is astig- 
matic, some of the lines in the de- 
fective meridian will appear much 
blurred while others remain clear 
and distinct. If the eye is normal, 
and no astigmatism exists, all of the 
lines are sharp and clear. But it is 



Astigmatism is a very common 



^^ 




Fig. 27. 
Astigmatic Chart. 



E 



Feet 



70 



C B 

DLXT 

P T S Rso 

FZBDS; 

O F L C T G 30 

AFEOSPSZ 20 
sntvsiBriie 15 



Fig. 28. 
Greatly reduced form 
of Chart for Testing 
Sharpness of Sight. 



found on examination that the very great majority 
of eyes are more or less astigmatic. 

The tests for sharpness of sight, or acuity of 
vision, as the optician calls it, is conducted by 
means of a chart containing letters of different 
sizes which the patient is directed to read at a 
distance. Upon the ability to do this is based 
the decision of normal or of defective vision. 
This chart is shown in reduced size in the illus- 
tration. The figures to the right of the letters 
indicate the distance at which the letter should be 
seen by one with normal sight. The card is hung 
upon the wall in a well-lighted position, and the 
subject is seated as far from it as the accommoda- 
tions will permit, but at some known distance, 
say 20 feet. The subject is then asked to read the 
letters in the line of smallest sized type which he 
can see plainly at that distance. His sharpness of 
vision is then expressed in the form of a fraction 
having 20, the number of feet that he is distant 



102 THE MAINTENANCE OF HEALTH. 

from the card, as a numerator, and the figures on the right of the 
line of type that he has just read, as the denominator. This 
fraction expresses his visual fraction. For instance, suppose he is 20 
feet away from the card and can read the line marked 20. The visual 
fraction is f a and the patient has stood the test. But suppose, at the dis- 
tance of 20 feet, he can read no smaller sized type than the line marked 30. 
Then the fraction becomes U, and, as this is a less fraction than U, his 
sight is pronounced defective. Each eye is tested separately. The fact 
that the patient successfully passes this test is no assurance, however, that 
his vision is perfect. It is, in that one respect, but there are other tests 
to which he must be subjected. 

There is a small type test card, such as is here given : — 



It is the duty of parents and of teachers to see that all 

of the conditions to which the children are exposed in 

school are such as will best promote their physical as 
well as mental growth and comfort. 



A patient less than 2 1 years of age should read this with ease when 
held at a distance of from 5 to 7 inches from the eye. If he cannot do 
so, but is obliged to hold it at a greater distance in order to see it clearly, 
there are indications of far-sightedness or of hyperopia, and his eyes 
should be examined carefully. If a middle-aged person cannot see it 
easily at a distance of from 10 to 12 inches, the same condition exists, 
and. reading glasses are necessary. 

Protection of the Eyes. — Nor is it alone in the direction of the 
remedy and the improvement that great care must be exercised. There 
are the strongest obligations upon all to protect and care for the eyes 
at all times. 

The first rule to be observed in reading and writing by either natural 
or artificial light is to see that the light falls over the left shoulder upon 
the book or paper. When one is choosing the location for a desk in an 
office, of a writing table in a room, or a seat for reading, this point is 
to be carefully observed. Ascertain the source and direction of the light 
from windows, then place one's self accordingly. By so doing the glare 
and brilliancy of the light does not shine into the eyes, but the paper or 
book is well lighted. When the eyes get both the direct light as well as 
the reflected light from the book or paper, there is an undue and unneces- 
sary strain upon them. The eyes themselves may be in deep shade so 



PROTECTION OF THE EYES. 103 

long as the page is sufficiently lighted ; and this is why green shades for 
the eyes, shades for student's and other lamps are used. The light is 
thrown on the book or paper but the eyes are shielded from the glare by 
the shade. 

Poor Light. — Reading by twilight or by fire light, not as a habit, 
but only on occasions when one has been caught in the most interesting 
part of a book, is far too great a strain for even good eyes to endure. 
When children offend unconsciously in this respect, it is better to quietly 
provide a suitable light as the quickest and easiest remedy, instead of 
ordering the book to be put away at such a climax, though a word of 
admonition and the pointing out of the certain injury which will result, 
should not be neglected. 

Strong Light in the Eyes. — Some, when in deep thought or in 
reminiscence, have a habit of looking long and steadily into a fire or at 
other bright lights. This constant glare of light is very trying to the 
eyes. It is true that there is a marvelous provision in the eye itself for pro- 
tection against the admission of too much light into the eye, by a won- 
derfully contrived shutter controlled by the "nerve of accommodation," 
as it is called; and this automatic contracting and dilating of the shutter 
under the varying power of light is a certain protection against the 
admission of too strong a light, yet it is not sufficient to counteract the 
effect or to prevent the injury which the habit just mentioned is sure 
to cause. 

Most emphatic protest must be made against the carelessness of 
some mothers and nurses in this regard with the eyes of helpless infants. 
Metaphysicians all agree that the first object which a young infant sees 
clearly is a light; and that it naturally manifests great interest in it, 
and is attracted by it. But that fact, however true, will by no means 
pardon the thoughtlessness which permits a young helpless child to be 
placed for hours on its back in its carriage with the full glare of the sun 
shining upon its blinking and unprotected eyes. Observation will show 
that this is a very common offense on the part of young and inexperienced 
nurse girls into whose care young children are so frequently and for so 
long a time intrusted. It is at this period, while the sense of sight is 
slowly developing, that the greatest protection is needed; but, unfortu- 
nately, it is at this very time that the child's well-being in this regard 
is so often disregarded. 

Care During Convalescence. — During convalescence from such 
diseases as measles, scarlatina, and typhoid fever, there is very special 



io4 THE MAINTENANCE OF HEALTH. 

need of all possible protection of the eyes. The sequelae, or after effects, 
of these diseases are sometimes more serious than the disease itself. It 
is well if the patient escape without some serious affliction which usually 
falls upon a weak or impaired organ. These diseases are extremely debili- 
tating, and the eyes, in common with the other organs, share in that 
debility, and are the last of the organs to recover from it. The light 
must be softened during the early days of convalescence. Later, a green 
shade or smoked glasses should be worn until the power and tone of the 
eyes are restored. 

Fine Print. — The caution against reading very fine print at any 
time, but especially in a dim light, while quite as important as ever, is 
not so necessary in this day of beautiful printing, clear, large type, and 
good book-making. 

Reading on Trains. — There is a very great temptation to while away 
the tedious hours of a long railroad trip with an interesting book. But 
this habit of reading on a train is one of the most fruitful sources of 
injury to the eyes. The shaking of the book by the motion of the car 
causes the distance of the book from the eye to constantly vary. The 
effort of the eye to adjust itself to this ever-varying distance is intensely 
tiring. The up and down motion of the page also causes the eye to 
follow the line with difficulty. ^With this there is also the ordinary right 
and left motion of the eye. So that when we stop to analyze the amount 
of work which the eye is obliged to perform by these three motions under 
trying circumstances in an hour of such reading, we realize the great 
tax upon it. 

Fine Work. — Close and continuous application to art needlework, 
embroidery, lace making, and fine sewing generally, is also trying to the 
eyes by reason of the fine stitches, the necessity of counting stitches and 
spaces, and very often the delicacy of pattern and trying, dazzling colors. 
In such occupation there is also the bending of the head over the work, 
with the attendant discomfort and injury of tight neckwear to impede 
the circulation of the blood. Positive and lasting injury to the eyes 
results from such strain and abuse. 

Floating Specks. — Nearly every one suffers at some time from 
little black, floating or falling specks which come within the range of 
vision and dance over the page when reading. These are called muscqe 
volitantes, or dancing flies. They are an indication of a debilitated and 
weakened system, and of a need of tonic and upbuilding treatment. 
They are caused by a lack of uniformity in the consistence of the liquid 



CARE OF THE EYES. 



105 




contained in the eye, which is produced by lack of nutrition or by a weak 

condition of the body. 

Need of Resting the Eyes. — The great sign that the eyes are being 

overtaxed is the aching of the eyes and pain in the eyeball. This warn- 
ing must not be disregarded. Rest of the eyes is then the great need. 

All, perhaps, have known the great relief to tired, watching, aching 

eyes that comes from looking out into the 
black, inky darkness of night, where no 
object is seen to occupy the eye. Frequent 
rest of the eyes, especially at night, is 
positively requisite whenever the eyes 
show the slightest signs of fatigue. 

Bathing the Eyes. — There are a few 
simple, harmless substances which may be 
used with benefit to bathe the eyes when 
they are tired or slightly inflamed from 
too steady use or from the action of the 
wind. Among them, are : cold water, hot 
water, a weak solution of salt and water. 
When the eyes are much inflamed, a cold, 
weak solution, or infusion, of green tea; 
or a teaspoonful of Epsom salts in a quart 

of warm water; or the addition of a little rose water to the bath will 

prove helpful and beneficial. But under no circumstances should any 

other lotion or eyewash be applied without 

a physician's advice. 

Foreign Substances in the Eyje. — 

When dust, cinders, eyelashes, and other 

substances lodge in the eye, do not rub it, 

for that only irritates the eye, inflames it, 

and increases the pain. Winking the eye 

also has the same effect. Keep the eye 

quietly closed, and, as the irritation increases 

the flow of tears, the chances are very great 

that they will wash the irritating body out 

of the eye. If they do not, one may take 

the upper lid at the middle part by the lashes 

and draw it gently down over the lashes of the lower lid, and 

allow it to slip back over them on its way back to place. This 



Fig. 29. 
First Step in Act of Everting 
or Turning Outward the Upper 
Eyelid. 




Fig. 30. 

Upper Eyelid Turned Out- 
ward. A. The Foreign Body. 



106 THE MAINTENANCE OF HEALTH. 

will often brush the foreign body out if it is lodged on the inner 
upper lid. If the offending substance is under the lower lid, that 
can be easily pulled down and the body removed. If it adheres 
to the ball of the eye under the upper lid, the latter may be rolled back 
over a lead pencil and the substance brushed off with a earner s-hair 
brush. The finger nail should never be used for this purpose, as it 
usually contains poisonous, irritating matter which only increases the 
injury. Eyestones are supposed to possess marvelous and mysterious 
power to extract substances from the eye. Their only use, however, is 
to raise the lid from the eye and to allow the tears to wash out the 
foreign body. Flaxseed will accomplish the same result. If the body 
is a sharp splinter of metal or similar object, which clings to or becomes 
embedded in the eyeball, the services of a physician are to be at once 
procured. Particles of lime in the eye are painful, not only by reason 
of their sharp corners, but chiefly on account of the burning and caustic 
effect upon the delicate membranes. Wash the eye at once with a little 
dilute vinegar, which, being a weak form of acetic acid, neutralizes the 
caustic effect of the alkaline lime, and, uniting with it, forms a harmless 
salt. The most effective means of administering a bath, lotion, or wash 
to the eye is by means of a specially made eye cup, which fits the hollow 
of the eye and insures long and steady application. 



CARE OF BONES. 

Bone undergoes a remarkable change from infancy to old age. In 
infants there is an excess of cartilaginous matter in the bones, which 
renders them very soft and little liable to fracture. It is during this 
early period that malformation of the bones is likely to occur. Bow- 
legs may be easily caused by permitting heavy children to stand or walk 
at too early an age. There is a great desire on the part of some parents 
to have a child walk or stand as soon as possible, and to this end they 
encourage it to support itself by a chair when the bones are soft, pliable, 
and unable to bear the weight of the child's body. Rickets, which some- 
times affect children, is caused by a deficiency of mineral matter in the 
bones, as a result of which they bend under the weight of the body. This 
condition is a manifestation of a weak constitution, and the disease is 
often aggravated by living in damp and ill-ventilated homes. Such chil- 
dren demand the best hygienic care; fresh air, sunlight, good, nourish- 



DEFORMITIES OF THE BOXES. 



107 



ing food, such as abounds in phosphates, cereals especially, and comfort- 



able clothing. 



Curvature of the Spine. — Curvature of the spine is the result of bad 
positions in sitting and sleeping, whereby the spine is bent from its nat- 




-■mm 

Fig. 31. Bowlegs. 




Fig. 32. Knock Knees. 



ural shape. The cartilage which separates the vertebrae, or individual 
members of the backbone, become compressed on one side and renders 
the distortion permanent. 

Bones of the Feet. — Mal- 
formation of the bones of the feet 
is likely to result from the bad 
habit of sitting on the feet, which 
is a common practice with some 
children. Malformation is also 
frequently caused by ill-fitting 
shoes. The toes are pinched to 
such an extent that they override 
one another, and the joints some- 
times become enlarged. The nar- 
row sole compresses the arch of 
the foot, and the high heels strain 
the ankle and thrust the weight of 
the body forward. 

Cracking the Knuckles. — The 




Fig. 33. Curvature of Spine. 



disagreeable habit of 



cracking 



the 



knuckles by pulling and pressing them causes an unsightly enlargement 
of the joints. 



io8 THE MAINTENANCE OF HEALTH, 

The Bones During Old Age. — In old age there is an excessive 
deposit of earthy matter in the bones, in consequence of which they 
become very brittle, and much more liable to fracture than at earlier 
periods of life. Not only that, but, when fractured, the bones of old 
persons knit more slowly and with greater difficulty. This in conjunc- 
tion with the failing sight, and other infirmities of age, enjoins the great- 
est care on the part of old people. 

Ligaments. — The bones are united, and in some cases held together, 
by bands of tough cartilaginous matter known as ligaments. Sudden 
wrenches and twists, often caused by slight accidents and by small objects, 
result in the stretching, straining, or sundering, of these ligaments, which 
produces a sprain or a dislocation. Usually the tendon or the ligament, 
when broken or torn away from its fastening at the end, heals or grows 
fast again. In such cases, the full use of the member is restored. But 
very often the lacerated or disengaged end does not attach itself again, 
and the use of the joint is impaired. The pain of a sprain, which is often 
more severe than that of a fracture, is caused by a wrenching of both the 
ligaments and the muscles. The swelling which ensues is caused by the 
escape of blood into the tissues, which also causes the discoloration. In 
a dislocation the force of the twist, fall, or blow is sufficient to cause a 
displacement of the bones of the joint, rendering any movement or use 
of the joint impossible. 

Diseases and Injuries to the Bones. — Sprains, dislocations, and 
fractures are the most familiar results of injuries to the bones. It is 
hard to tell which is the more to be wondered at, the slight accidents 
which often produce the most grievous consequences, or the marvelous 
escapes from serious injury. Children escape certain injuries by reason 
of the softness of the bones ; old persons are more liable to such injuries 
because of the greater brittleness of the bones. Intoxicated persons 
make no effort to save themselves when falling, and the bones are not 
rigidly fixed by the tenseness of the muscles with which sober persons 
attempt to break the force of a fall. Sleepwalkers, sleeping children, 
and others, have bad falls with no serious effect, as they, too, are uncon- 
scious of danger, and make no effort to save themselves. 

A bone is subject to death even while in the body. Such a state is 
known as necrosis of the bone. Death of a bone is caused by anything 
which interferes with the circulation of the blood in the bone. Such 
interference may be a severe injury, the separation of the covering of 
the bone (the periosteum), inflammation of the bone, of the marrow, 



CARE OF THE MUSCLES. 109 

or of the periosteum. Death of the inflamed bone always causes a secre- 
tion of pus, which finds its way to the surface. The most serious con- 
dition in which death of the bone results is that commonly known as 
hip-joint disease. In this the upper part of the long bone of the thigh 
dies., and its removal by surgical means is required. Inflammation of 
the kneejoint is often produced by very slight knocks or blows, so slight 
that they are forgotten until the pain in the joint sets the patient think- 
ing. A stiff kneejoint is very often the result. 



CARE OF THE MUSCLES. 

The proper care of the muscles of the body is largely a matter of good, 
nourishing food (for which see page 26) and of exercise. 

Exercise. — The direct effects of exercise upon the muscles are an 
increase in their size, density, and compactness, and a marked darkening 
of the color of the flesh. With insufficient exercise, the muscles decrease 
in size and become pale, flabby, and soft. The dark color of an exercised 
muscle is due to the larger supply of blood which it acquires through use. 
For this reason we do not choose dark-colored beef, as this darker color 
is an indication of much exercise and consequent toughness. The increase 
of a muscle in size by use is well illustrated by the great development of 
the breast muscles of pigeons, which are so constantly brought into use 
in long flights. The flesh becomes discolored and dark from the freer 
circulation of blood in the parts. The breast of a chicken is smaller in 
comparison, and is light-colored from lack of use, while the legs and parts 
most exercised supply the dark meat. 

Violent and long-continued exercise is injurious because there is 
greater waste and destruction of tissue than food and bodily functions 
can repair in the same time. There is a great difference between exercise 
for health and the systematic training of a professional athlete. A man 
who trains all of the time, and keeps himself always "in condition," be- 
comes prematurely old and usually breaks down in middle life. 

One of the most important laws of health is aimed directly at the man 
who leads a sedentary life : A sedentary life needs daily, moderate exer- 
cise, never carried to the point of fatigue. "No organ of the body, no set 
of organs, nor the body itself, can be maintained in a normal and healthy 
condition unless its parts are fully exercised.'' The exercise of the muscles 
is not limited in beneficial effects to the muscles themselves ; but regular 



no THE MAINTENANCE OF HEALTH. 

and systematic exercise is of the utmost importance to the full develop- 
ment and the well-being of the body as a whole. 

Special Value of Exercise. — The muscles of the body, as has been 
stated, cannot be strong, and cannot perform their functions well, without 
regular and intelligently planned exercise. This is true of both the invol- 
untary and the voluntary muscles. By involuntary muscles are meant 
those which act regularly, without requiring any effort of the will power 
or the attention. 

The lungs are benefited by exercise chiefly in the direction of throw- 
ing off the carbonic acid gas more liberally and completely. The neces- 
sity of drawing long breaths which exercise entails is the means by 
which this is done. The statement that a healthy body is an impossi- 
bility without proper breathing and a sufficiency of good, fresh air, will 
bear repetition, so important is this point as a preliminary in the acqui- 
sition and retaining of good health. The purity of the blood depends 
upon plenty of oxygen, and the health of the several organs and the 
parts of the body depends upon the purity of the blood. Deep, efficient 
breathing of fresh air is the first rule of good health to all, but espe- 
cially to those who follow sedentary occupations. 

The circulation of the blood is benefited by the increased action of 
the heart which is induced while exercise is being taken. The heart 
beats more rapidly, the pulse is stronger and fuller. The blood is 
sent coursing to the extremities, the brain is well supplied with fresh, 
rich blood, and the whole system, both physical and intellectual, responds 
to the exhilaration. The lawyer, the student, the business man, who 
have wrestled with perplexities and problems in the office and the study, 
find great clearness of mental perception in the refreshing walk. Many 
a knotty problem or difficult question finds easy solution on the golf 
links, by the seashore, or in the country lane. If the exercise has been 
violent or carried to the point of fatigue, it will be observed that the 
heart and the pulse rate rapidly fall below the normal. It is then that 
the care of the body in the way of clothing and rest is most needed. 
Excessive exertion may cause palpitation and valvular disease of the 
heart as a direct consequence of the great demands that are then made 
upon that organ and of its effort to quickly repair the waste which goes 
on so rapidly. If disease of the heart is known to exist, it is suicidal 
to indulge in violent exercise. Even the act of running for a train or 
car, or of walking rapidly uphill, may be the cause of a rupture of 
some weakened or diseased organ or part of the heart ; and this explains 



EFFECTS OF EXERCISE. in 

some of the cases of sudden death which follow such indiscretions. 
But this danger should not lead to the other extreme, the neglect of all 
exercise. There are many forms of gentle, moderate exercise which 
are perfectly safe for those with "heart trouble" to practise with benefit ; 
for a deficiency of exercise is often the direct cause of a weakened heart 
and, in some temperaments, of fatty degeneration of the heart. 

The skin during exercise becomes red because with increased circu- 
lation the blood is forced with unusual vigor to the surface capillaries, 
or minute blood vessels, in all parts of the body. As the temperature 
of the body increases, the perspiration glands begin their work of cool- 
ing the body. At this stage another very important law of health must 
be observed. These pores must be allowed to close gradually. To 
effect this, as soon as the exercise is completed, heavier, protective cloth- 
ing must be thrown around the body and a gentle walk should be taken 
in order, as it is often said, to let the body cool off slowly. Really it is 
to prevent the pores of the skin from closing too rapidly and thus 
checking the perspiration too soon. Sudden cold, or cooling, sitting 
in a draught, or similar exposure closes the pores suddenly. The per- 
spiration is then checked and has no escape except through the kidneys. 
This sudden interruption of one of the body's spontaneous efforts to 
adjust the temperature to new demands and unusual conditions results 
inevitably in a cold in one or more of its dangerous forms. The same 
result is brought about by throwing one's self after heating exertion on 
damp grass or on the cold ground, or by taking a cold bath, or swim- 
ming when overheated, or indulging in similar indiscretions. Young 
people who are not informed of the danger of such practices are inclined 
to think that those who advise against them are treating them with a 
coddling, unmanly care. But the horse trainer knows better than to 
neglect to exercise his horse under a blanket after a race, and never 
thinks of turning him at once into the stable or of letting him drink 
cold water after a hard drive. A dog, however, may swim and lie in 
the water as much as he pleases when suffering from the heat, for he 
has no pores on his body to close ; he does all of his perspiring by means 
of his mouth, and this accounts for his deep panting, open mouth, and 
protruding tongue, on hot days and after violent running. 

The nervous system is benefited mainly by the flow of blood to the 
brain. Whatever improvement of the nerves, whether motor, sensory, 
or sympathetic, results from exercise, or, indeed, from any cause, must 
come from the brain ; for that organ controls the entire nervous system. 



ii2 THE MAINTENANCE OF HEALTH. 

That which improves the brain, improves the nerves'; and that which 
injures the brain, injures the nerves. Moderate exercise renders the mind 
clear and active. Change of scene, of occupation, and of associates, 
have a most beneficial effect along the lines of rest, for mental rest may 
proceed simultaneously with bodily activity. Deficient exercise dis- 
plays its effects upon the nervous system by morbid excitement, ennui, 
melancholy, and mental hallucinations, especially in the case of persons 
of a highly-sensitive nervous organization. Exercise in the fresh air 
and sunlight are large and important factors in the treatment of nervous 
diseases. 

The digestive system is much benefited by judicious exercise. The 
appetite increases because there is a waste of tissue to be repaired, which 
does not occur to such an extent in a state of rest or of inactivity. The 
food digests better; and its absorption into the blood after digestion is 
both greater and easier. The circulation of the blood in the liver and 
in the abdomen is improved, and this is attended by a better perform- 
ance of the functions of these important organs. On the other hand a 
deficiency of exercise lessens the appetite and diminishes the digestive 
power. The food which is taken into the body is not fully acted upon 
and it remains in the stomach, where, to a greater of less extent, it 
decays rather than digests. This means an impairment of the bodily 
health and a long train of disorders of which constipation and poison- 
ing by the absorption of faecal matter are not the least. A great and 
mischievous error is committed by many at this stage in seeking a 
remedy in the free use of purgatives and aperients. Not only do people 
bring this deplorable condition upon themselves by neglect of the simple 
and natural means of exercise to prevent it, but they then seek to use 
force to compel the bodily organs and functions to conform to these 
unnatural and unhealthful habits of living. Such unreasonable forms 
of relief are often called a means of assisting nature. There is practi- 
cally no case of constipation brought on by an indolent habit of life or 
by sedentary occupation that will not, in time, yield to the treatment of 
moderate exercise, regularly performed, aided by a liberal, fresh fruit 
diet. 

Perhaps the most noticeable effect of exercise upon the bowels is the 
relatively small amount of refuse or waste matter that is thrown off by 
them as excreta. This is a convincing proof of the benefits of exercise 
upon digestion. By its means more of the nutritious matter is extracted 
from the food and is absorbed into the system. There can be no true 



QUANTITY OF EXERCISE. 113 

condition of health when a certain amount of nourishment supplied to 
the body is, through neglect and carelessness, to a large extent thrown 
away unused. It is one of the first principles of commercial economics 
to get the largest possible returns of manufactures from a given quan- 
tity of raw ^product; and so it is one of the first principles of physiolog- 
ical economy to derive as much nourishment as possible from a given 
quantity of nutritious food. 

Quantity of Exercise. — Attempts to prescribe the amount of exer- 
cise a healthy adult should take in a day are based upon as accurate, as 
possible, an estimate of the work done in a day by a man engaged in 
manual labor in the open air. Such is regarded as the most healthful 
life possible. A man so engaged will put forth in a day as much strength 
or force as will suffice to raise from 250 to 350 tons one foot. It would 
seem then that the minimum of daily exercise to be taken by an average 
man should be not less than the expenditure of sufficient force to lift 
about 150 tons one foot. This force is expended in a walk of about 
nine miles. Taking into consideration the fact that every one in the 
pursuits of daily life puts forth considerable exertion, this amount is to 
be reduced according to the amount of force so expended. No rule can 
be laid down which will cover all cases, but it is possible, from the facts 
stated above, to fix the amount required in any case with tolerable 
accuracy. 

Form of Exercise. — Much has been said and written about this and 
that series of "movements" ; and many ingenious forms of physical 
exercises have been devised, with and without elaborate apparatus and 
contrivances. But it would appear that many of these new forms have 
been made interesting and attractive in order to coax us to give up a 
small part of our time each day to such exercise as is really necessary 
to the healthful development and proper nourishment of our bodies. It 
is not sufficient that an intelligent person be told that if he move his 
arms or his body in this or that direction, so many times each day, that 
this or that result wijl be reached. Knowing only so much of one or 
more of the many forms of physical culture so strongly advocated, and 
so speedily superseded, it is no wonder that thinking, reasoning persons 
tire of them and so soon neglect them. With the full and plain descrip- 
tion of anatomy and physiology given in another portion of this work, 
anyone who desires to improve the general condition of the body, or to 
supply any special deficiency, may do so with intelligent effort and per- 
sistence in the very simple forms of exercise here recommended. Unless 



ii 4 THE MAINTENANCE OF HEALTH. 

one knows the end one is trying to reach, and the means one is employ- 
ing to reach that end, there is small likelihood of either intelligent or 
persistent effort, without which practically nothing of lasting benefit 
can be accomplished. 

Walking. — For general development, vigor of body, and the full 
maintenance of health, no form of exercise can compare with walking. 
This exercise, so much demanded in business and domestic life, is, when 
properly conducted, one of the most beneficial forms, and the most 
easily practised. Care must be taken that when performed, whether in 
the office, the home, the street, or the country, every step be taken 
correctly. For, apart from the great physical benefits which it confers, 
one must not forget the charm of an easy and graceful carriage. There 
are those who most conscientiously take a formal walk for exercise 
every day, during which they carefully practise all the correct observ- 
ances which they wantonly neglect all the rest of the day. 

So awkwardly and inefficiently is this commonest of all acts per- 
formed by the average man, that the first thing taught to one joining 
the army is how to walk, and, incidentally, how to stand, correctly. All 
recruits are obliged to go through the drill of attention and the ''goose- 
step" to insure that erectness of carriage and that ease and grace of 
motion for which a well set-up soldier is noted. 

A good walker carries the head erect with the chin slightly drawn 
in or down ; shoulders square ; chest raised ; hips drawn in ; toes pointing 
slightly out; heels striking the ground first, afterward the ball of the 
foot, evenly; the walker finally springs from the toe after the manner 
of the square heel-and-toe of the pedestrian. The exaggeration of any 
of these points is, perhaps, more ludicrous and ungraceful than 
the disregard of them. One is not always conscious of faults of gait 
which are apparent to others. These can be corrected by soliciting 
kindly criticism from one in whose judgment we have confidence, and, 
in this way, learning our shortcomings. 

Walking and the mode of carrying the body constitute an indispen- 
sable part of one's appearance in public, and one owes it to one's self 
that this be, as far as any personal effort and painstaking can make it, 
graceful, easy, healthful, and calculated to create a favorable impression. 

It is, perhaps, hardly necessary to say that no one can walk well or 
gracefully in uncomfortable and ill-fitting shoes. It is to be remarked 
in this connection that as much, or more, actual discomfort may be 
suffered from wearing a shoe that is too large as from one that is too 



WALKING. 115 

small, to say nothing of the added ungainly appearance. Too much care 
cannot be paid to the proper fitting of the foot; nor too little attention 
to the dealer's assurance that some detail of poor fit will be all right 
after the shoe has been worn a few days, when the shoe will take the 
form of the foot. Too often, under such circumstances, the foot takes 
the form of the shoe. 

Slow walking, or sauntering, is really more tiring than is a brisk 
steady gait. In walking uphill the body should be inclined forward 
and the steps taken should be short. 

The habit of starting out to walk to a certain point with the fixed 
purpose of walking just so far for the sake of exercise and with no 
other thought than that of performing a duty, is not generally beneficial. 
Nor is it well to go alone when it is possible to have congenial compan- 
ionship. In the solitary walk the mind is less likely to be freed from 
the cares of business or domestic duties or from study or worry. But 
be sure that the companion is congenial ; an uncongenial companion may 
render an otherwise beneficial walk quite harmful. One should try to 
walk in places where there is something interesting to engage one's 
attention. 

It would seem worse than idle to recommend this form of exercise 
purely as a means of developing the muscles to those who in the dis- 
charge of their duties are obliged to walk a great deal. If a walk is 
devoid of recreation, pleasure, change, or the benefits of fresh air, by 
all means let some other exercise be chosen. Still, there remains to 
such persons, in common with all who walk, the need of observing that 
each step be taken with marked attention to correctness of gait and 
grace of bearing, which is so essential to both health and charm. 

After a comparatively short time, if strict attention be paid to these 
points, the habit of correct and graceful walking will be so confirmed 
that it will be well-nigh impossible to fall back into a slouchy or ungainly 
gait or faulty and ungraceful carriage. 

Under no circumstances should walking, or, indeed, any form of 
exercise, be carried to the point of extreme fatigue. There is such a 
thing, however, as a healthy weariness which insures all the pleasure 
of rest and of sound sleep, which makes walking and similar forms of 
exercise Nature's remedy for insomnia. By all means let the walk be 
taken as a recreation, not as a perfunctory or disagreeable duty to be 
performed. It is the basis of golf which, after all, is but a game of a 
long- walk with pleasant companions and the recreative adjunct of skill 



n6 THE MAINTENANCE OF HEALTH. 

and the correct estimate of distance. The camera, the botanical tin for 
collecting specimens, the sketchbook, or the paint box may be the form 
of recreation added to the walk. To the observant mind and the lover 
of nature, there is a rich fund of enjoyment and food for rational con- 
templation in a walk by field and stream. Nor is the exercise to be 
confined to fine weather alone. A good bracing walk in stormy weather 
has its charms and pleasures for one who is properly clad and protected 
against all inclemency. But one must be sure that there is no exposure. 

Running. — This form of exercise is largely restricted by custom to 
the young of both sexes and to men. As it is more violent than walk- 
ing it produces more marked results. The circulation of the blood is 
greatly increased and, with it, the temperature of the body and the 
number of respirations per minute. It is possible with regular practice 
to develop in a very short time the power of keeping up an easy dog- 
trot for several miles. While the entire body is greatly benefited by 
running, the special development is in the legs. But the gentle, regu- 
larly sustained back and forward motion of the arms in a long run is 
one of the best possible preliminary exercises for arm improvement. 
The arms are bent at the elbow and are carried at the sides of the chest 
with a very slight motion. Violent motion of the arms in running is a 
useless expenditure of strength, which is better conserved for legitimate 
use. Fast running for a short distance, or sprinting, consists in the 
power of taking long steps very rapidly. But long distance running at 
a moderate pace is much the better form of exercise, although, as a 
sport, it spoils one for short distance running. The behavior of the 
breathing in long distance running is very peculiar, in that the runner's 
"wind" fails him after a short distance has been covered; then, after a 
short period of rather labored breathing, the "second wind" comes and, 
usually, stays with him. It is conceded by runners that the use of 
tobacco very materially injures the "wind" of runners and athletes gen- 
erally. Sometimes running is attended with pain in the side; upon the 
occurrence of this the runner should instantly cease exercising until such 
pain passes off". The great danger to be avoided is in exposure on 
cooling off after a run. A wrap should be thrown around the body 
and a walk should be kept up until the temperature of the body is re- 
duced. Drinking cold water and throwing one's self on the ground 
when overheated are often followed by very serious consequences. 

Physical Exercise for Young Persons. — No formal physical exer- 
cise or gymnastics should be encouraged before the fifth year. From 



PHYSICAL CULTURE. 



117 



that up to the eighth year such exercises as are employed must be very 
simple. The child is growing fast and the muscles in their imperfectly 
developed state cannot perform double or intricate movements. The 
games that children play, and play so poorly compared with an older 
person, are both a sufficient exercise and at the same time a proof of 
their inability to bring several sets of muscles into efficient use at the 
same time. 

From the eighth to the twenty-first year is the time for formal 
physical development. That is the period of life when the body will 
most easily respond to right efforts towards carriage and development. 
The youth is well able to take part in those games which call forth a 
variety of complex movements of both body and mind. 

The exercises which are given below are designed for general mus- 
cular and physical culture. The following points should be observed in 
the practice of them : — 

1. They are best practised in the morning on rising. 

2. Let the clothing be light and loose. 

3. Drink plentifully of water both before and during the practice. 

4. Lower the windows from the top and raise them from the bottom. 
Have plenty of air but no draughts. 

5. Do not perform the motions in a listless manner. Act as though 
you were meeting resistance in the motions. Play one muscle against 
another. This does not mean a jerking motion, but a steady pull or 
strain of the muscle. If the exercise is taken in this way the use of 
weights or dumb-bells is not advised. The artificial resistance is better 
than the weight. 

6. Perform with accuracy and pre- 
cision and with a determination to get the 
most possible good out of them. 

7. Rest for about a half minute be- 
tween each movement. 

Exercise I. Bending and Stretch- 
ing. — Raise the hands to the full extent 
above the head, palms to the front. 
Stretch as high as possible. Keep the 
body erect and the upper part of the body 
raised as high as possible with a reaching 
motion. Bend the body at the hips and 
try to touch the floor with the tips of the 





Fig. 34. 
Position i. 



Fig. 35. 
Position 2. 



n8 



THE MAINTENANCE OF HEALTH. 




Fig. 36. 

Position 2. 



fingers without bending the knees. This may be impossible, but come 
as near doing so as you can. Straighten up, restoring the hands to the 
former position. Repeat slowly ten times. 

Exercise II. Bending the Body Forward and Back. 
— Place the hands on the hips, with the fingers towards 
the front, and thumbs back. Bend the body forward 
until it is at right angles with the legs. Keep the back 
straight. Then bend backward, supporting the back with 
the hands still upon the hips. Begin with ten times and 
gradually increase to thirty. This is an excellent exercise 
for a weak back or for reducing excessive fat on the 
abdomen. 

Exercise III. Rotating the Body on the Hips. — 
Place the hands on the hips, arms bent at the elbows, 
thumbs to the rear, fingers to the front. Turn the head so 
that the chin is over the right shoulder, eyes looking to the right. Slowly 
and with resistance to an imagined opposing force, turn the body on the 
hips so that the right shoulder comes to the front. Reverse the exercise by 
letting the right shoulder go back and the left shoulder come to the front. 
If this exercise is performed rapidly and with a swing, the rotation of 
the body on the hips will be greater in extent but not so 
beneficial as when performed slowly and with resistance. 
Repeat ten times at first with a gradual increase in the 
number of times and in the vigor of the exercise. The 
muscles of the back and of the abdomen are greatly bene- 
fited by this motion. 

Exercise IV. Bending the Body Sideways and 
Back. — Raise the hands above the head; bend the body 
at the hips toward the right side, head and chin raised so 
as not to interfere with the circulation and the breathing. 
Straighten up and carry the body as far backward as 
you can, with the head thrown back. Repeat the move- 
ment ten times at first ; gradually increase in vigor. This 
strengthens the muscles of the abdomen and the back. 

Exercise V. Bending the Body to the Side. — Stand 
with the arms hanging naturally at the sides, body erect. Bend the body 
to the right, at the same time reaching down as far as possible with the 
right hand, and raise the left arm straight up and in line with the right 
hand. The eyes are to be directed downward. Straighten up and bend 



Fig. 37. 
Position i 



PHYSICAL CULTURE. 



119 




Fig. 38. 
Position i. 



Fig. 39. 
Position 2. 



down as far as possible to the left, reaching downward to the full extent 
with the left hand and raising the right hand above the head, with the 
eyes directed downwards. Do not let the body incline backward or for- 
ward in this practice. It is a beneficial exercise for the muscles of the 
abdomen and the back. Repeat it 
ten times, gradually increasing. 

Exercise VI. Abdominal Ex- 
ercise. — Lie at full length on the 
floor upon the back. Place the hands 
upon the hips. Imagine that a 
weight rests upon the feet. Slowly 
raise the feet, without bending the 
knees, so that the legs are at right 
angles with the body. Gradually 
and slowly drop the feet and legs to 
the original position. Repeat ten 
times and gradually increase. When 
rightly performed this is a test of 
the strength of the abdominal mus- 
cles. Do not overdo it. 

Exercise VII. Arm and Body Exercise. — Lie full length on the 
face on the floor. Place the hands, palms downward, on 
the floor under the shoulders. Slowly raise the body from 
the floor to the full extent of the arms, keeping the tips of 
the toes on the floor. Very slowly lower the body to the 
floor without resting it upon the floor, and repeat the exer- 
cise only five times at first, gradually increasing it. 

Exercise VIII. Development of the Calf of the Leg. — 
Place the hands upon the hips. Raise the body on the toes. 
By bending the knees, slowly lower the body to a sitting 
position still resting on the toes. Resume the first position. 
Begin with ten times and gradually increase to thirty. 

Exercise IX. Going Upstairs. — This exercise can be 

put into practice as the occasion requires. There is no more 

beneficial treatment of the legs than this when properly done. 

We have been doing it so regularly and from such an early 

age that we do not realize that the act is a very nice and difficult balancing 

feat. II we stop to think of the number of falls a child receives while 

he is learning the art of going up and down stairs, or if we think of the 




Fig. 40. 
Position i. 




120 THE MAINTENANCE OF HEALTH. 

trouble we nearly all experience on strange stairs in the dark, we shall 
begin to appreciate its difficulties. So great is the difficulty of preserving 
the balance of a body, the center of gravity of which is constantly chang- 
ing, that when the first Japanese embassy visited Europe several years 

ago, there was not one of its mem- 
bers could go up and down stairs 
without clinging to the hand-rails. 
And yet those people had gone up 
Position i. and down ladders at home in their 

houses with agility. In going up- 
stairs incline the body forward. Many do this incorrectly by simply 
dropping the chin upon the chest, which interferes with the breathing 
and the circulation. Take the first stair with the left foot, raising the 
body at the same time on the toe of the right foot. This is important, 
as it exercises the large muscle of the calf of the leg. Do not place the 
flat of the foot on the stair. Come down on the toe and carry the weight 
of the body on it. Ability to go up a flight of stairs on the toes is an 
indication of vigor and freshness. The flat foot on the stairs is an indi- 





Fig. 42. Fig. 43. 

Position i. Position 2. 

cation of illness or of weariness. On going downstairs, carry the body 
erect, not inclined forward in the act of looking at the steps ; let the eyes 
do that while the body is erect. Let the weight be carried on the toes. 
The muscles that are employed in this are the walking muscles, but there 
is the added weight of the body. In going up one flight of stairs the 
subject is not only going forward, but is raising the weight of the body 
a height of ten or twelve feet. It is like climbing up a very steep hill 
with a good footing. Of course a woman is at a great disadvantage in 
going upstairs with one hand full of skirts and a few things in the other 
hand, and few of them perform the act well or gracefully. But there 
are many who so appreciate the great benefit of the exercise that they 
seldom use an elevator except in long trips. 



THE NERVOUS SYSTEM. 121 

Bicycling. — It must be remembered that the set of muscles which 
are brought into play in bicycling are not the same as those used in walk- 
ing. The bicycle muscles are the same as the 
skating muscles. And we all know that, no matter 
how well developed the walking muscles may be, 
we feel keenly the soreness and stiffness which fol- 
low the first day's hard skating. The large 
muscle of the calf of the leg is a walking muscle, 
but does not come into use to an appreciable extent 
in either bicycling or skating. This is largely be- 
cause there is slight need in the latter acts of raising 
j^, the weight of the body upon the toes. So that both 

Position 2. bicycling and skating are good supplemental exer- 

cises to that of walking and running. 




THE NERVOUS SYSTEM. 

There is such close and intimate relation between the mind and the 
body, between the nervous system and the bodily functions, that what- 
ever injures or impairs the one, in similar measure injures or impairs 
the other. This was fully appreciated by the ancients, who regarded "a 
sound mind in a sound body" as the ideal of the perfect development of 
mankind. Good food, fresh air, and proper proportions of exercise 
and rest, of work and recreation, are as necessary to the development of 
the brain as to the growth and sustenance of the body. 

Sleep, natural, regular, and profound, is the first duty we owe to the 
nervous system. It is during that period that Nature is building up 
again what has been lost during the waking hours. The safe rule is to 
sleep until one wakens naturally. No fixed number of hours can be set. 
Much depends upon the occupation; — brain workers and children re- 
quire more hours of sleep than do hand workers and old persons. The 
best sleep is that induced by Nature and unattended by dreams. Sleep 
obtained by drugs or medicines is not so beneficial as is natural sleep. 
It is supposed that the medicine by reaction disturbs the nervous system 
and neutralizes the value of sleep. Under no circumstances should 
drugs be used without the sanction of a physician. To those suffering 
from the fearful affliction of insomnia and driven almost to desperation 
by their terrible condition such advice may seem unsympathetic and 



122 THE MAINTENANCE OF HEALTH. 

trite. But rather a thousand times the ills of insomnia than the fear- 
ful thraldom of the drug habit. One suffering from insomnia should 
be very careful of his every act, but especially of those within six hours 
of the usual time of retiring. No tea or coffee, no study, no more 
worry than possible, no excitement during that time, and as much resig- 
nation and calm, deliberate fighting the demon of unrest as can be sum- 
moned, will go far towards a conquest; — not, perhaps, the first night, 
or the second, or the third; but persistence must orevail. Let all of 
this be accompanied by a hot bath, as hot as can be comfortably borne, 
to allay nervousness. Many are the suggestions for a remedy, some 
very ridiculous, but nearly all pointing to the direction of concentrating 
the mind upon something other than upon one's unfortunate condition 
and of striving to forget one's sufferings. Insomnia, or sleeplessness, 
is a symptom or sequel of other conditions. Permanent relief can be 
found only by the removal of the cause. Temporary relief is afforded 
by such treatment as will draw the blood, from the brain and so prevent 
its activity; for the brain cannot act without blood. Such means are 
the hot bath, a brisk walk before bedtime, moderate diet, and outdoor 
exercise. 

Indiscretions in eating and drinking are always accompanied by 
sleeplessness. The consequent disordered stomach and more or less acute 
indigestion are the causes to be removed. Whatever the cause it must 
not be ignored or temporized with; for sleeplessness is one of the most 
alarming symptoms of a nervous or mental collapse. 

Neurasthenia, or Nervous Prostration, is the breakdown of the nerv- 
ous system after a period of nervous excitement or strain. It is 
Nature's rebellion against bad treatment, — either enforced or willful. 
It is the almost general custom to ascribe it to overwork. The human 
body is so protected and safeguarded by bountiful provisions and adap- 
tation of parts to their uses, that no taxing of its powers beyond its 
strength is possible by legitimate means. There is no such thing 
possible as prosecuting work along legitimate lines to injurious lengths. 
No amount of healthy work can be held responsible for nervous collapse. 
There are always other reasons for a breakdown. If, during the hours 
which should be properly devoted to rest and sleep, there are social and 
intemperate excesses, irregular hours and late suppers; or if there be 
worry in any of its many phases; undue excitement; mental agony or 
distress; any of these, alone or in combination, may in time produce 
this condition. Invariably it is one of Nature's last warnings that all 



NERVOUS PROSTRATION. 123 

of her plain and simple laws of health are being ruthlessly disregarded, 
that all of her rights are being persistently invaded ; and that it has gone 
on until she most positively protests against a continuance of it. 

That this nervous collapse is far too prevalent is attested by the 
number of sanitariums and health resorts established throughout the 
country. It has come to be considered as one of the inevitable results 
of present day conditions of life, both domestic and business. There are, 
however, indications of a protest being gradually but steadily entered 
against life and its hard conditions and exactions. Business men are 
showing an inclination to go slow; to observe shorter hours; and to 
take more recreation and regular vacations. The unwisdom of inordi- 
nate ambition and its fierce struggle is gradually being borne in upon 
the minds of all classes; and moderation, the keynote to all permanent 
and enjoyable success, is still recognized as the safest course to pursue. 
It is not the struggle for existence that brings such a state of health to 
the business man so much as the struggle for high place. To the student 
with mediocre ability, to the business man of limited capital and few 
connections, to the professional man with slight popularity, to the 
social aspirant with small income, the spur of unreasonable ambition and 
of too lofty aspiration brings the worry, the struggle, and the dis- 
appointment that kill. In face of such penalties and sufferings the 
resignation and contentment which make one satisfied to walk in that 
state of life to which it has pleased God to call one, is almost envi- 
able. 

The treatment of neurasthenia consists chiefly of rest, sleep, change 
of air and scene, and removal from the customary surroundings and 
associations. Sympathetic and cheerful companions, good diet and 
nursing, proper medical treatment, and, above all, the necessary disci- 
pline of regular hours, baths, medicine, and complete change of the 
manner of living, will, in time, restore much of the former good health. 
But even then, great care in the mode of life, observance of the laws 
of health, and moderation and much self-denial will be needed to pre- 
vent a recurrence which will in the second case be more easily provoked 
than at first. 

Overwork. — As previously stated, this term is much misused. 
There is, however, a form of overwork concerning which parents should 
be very careful; that is the overtaxing of the young mind before the 
mental powers are fully developed. There is a great temptation, 
especially when a young child shows an unusual degree of precocity, to 



i2 4 THE MAINTENANCE OF HEALTH. 

encourage a too rapid mental growth. There is more than ordinary 
danger of this in the case of an only child who is brought up in the 
company of his elders and is denied the companionship of young chil- 
dren of near his own age. The more nearly equal mental attainments 
of such companions is a safeguard against such severe mental strain as 
the intercourse with grown people too often excites. Such a child is 
usually sent to school at too early an age and so the process of forcing 
is continued, to his great detriment. Remembering the very intimate 
relationship existing between the mind and body, it must appear that 
such a child's intellectual development is being hastened at the expense 
of his physical growth. The only encouragement that such a child 
should receive is along the lines of observation. He should be encour- 
aged to gather his knowledge of his environment and of the things near- 
est to him by the senses of touch, sight, and hearing. 

AYhen the brain is developed and the mental processes are active, 
there is slight danger of a boy or girl suffering from overstudy. Given 
a good physical development a parent need have little concern with the 
possibilities of a child injuring himself by a too close application to 
study. In the case of children of weak constitution and of a nervous 
temperament, care must be taken that such a one devotes as much 
attention as possible to physical culture and outdoor life. If the body 
is built up and kept up, the brain will grow strong at the same time. 

A great deal has been said of the injury of "cram" for examinations. 
Now, the ability to master a subject, or to gain a good knowledge of its 
principles in a short time and under pressure, is an accomplishment that 
should not be despised. The lawyer does just such work on every case 
he takes up. He must get a grip upon a subject within a very short 
time which will enable him to intelligently conduct his case and even to 
examine and to cross-examine experts in the interests of his client. 
This knowledge is put aside when the case is through and a new subject 
is taken up in the same way. The medical man and other professional 
men are often called upon to do the same thing. In the case of chil- 
dren the great objection is that the method is not pedagogically sound 
and is at variance with the proper principles of education. There is 
slight danger of any injury, either physical or mental, resulting from it. 

Anger and Passion. — The nervous system is so delicately balanced 
and so intimately connected in its control of the functions of the bodily 
organs, that violence of temper and manifestation of extreme passion 
and motion are constitutional in their disturbing effects. History is 



A STOCK OF ENERGY. 125 

full of even fatal results from an outburst of anger. Sylla, Valentinian, 
Nerva, Wenceslas, and Isabeau of Bavaria all fell a prey to a sudden 
access of passion. The numerous instances in all ages of temporary 
insanity with attendant crimes of murder, and self-destruction induced 
by violence of passion, all attest the utter derangement of the brain 
under their influences. It is a complex metaphysical and physiolog- 
ical question which confronts one in an attempt to fully explain all of 
the reasons why the body, its organs, functions, and the general health 
are so shocked and disturbed by anger, hate, and the painful affections 
of the soul, and even by intense joy. Certain it is that the blood is 
suddenly and violently congested in the lungs and brain. The nerve 
centers of the brain and spinal column are paralyzed, the heart beat 
and the breathing are interrupted and decline. The liver is so affected 
that the bile is increased and is absorbed into the system so that jaun- 
dice sometimes results. Apoplexy results from the congestion of blood 
in the brain. In repeated indulgences the effects are cumulative and in- 
duce loss of appetite, indigestion, and affections of the brain. The log- 
ical hygienic conclusions from these facts are that one must avoid all 
strong emotions and intense pleasures; and meet the sorrows and 
agonies of life with philosophical resignation and equanimity. In such 
conditions work and occupation to employ and divert the mind and to 
render one proof against the temptations of idleness is one of the 
greatest blessings of life. 

A Stock of Energy. — We are often struck by the wonderful display 
of physical and nervous energy by persons of fragile appearance at 
critical times. The storing up of nerve force and of supplies to with- 
stand sudden and severe demands is well provided for in the physical 
economy. Nature always looks ahead in the most prudent way. She 
stores her surplus force in reservoirs all over the body in varied forms 
to guard against both the irregular supply of food and unexpected 
drafts upon her resources. If this were not so, man could not go, as 
he often does, for long periods without food or sleep. He lives during 
such periods upon the stock of energy which Nature has laid up for 
him. Especially is this remarkable in the case of brain work. The 
worker may arouse himself with stimulants at such times, but he only 
drugs the guards of pain, hunger, anxiety, and weariness which warn 
him of approaching exhaustion and fatigue. Physical and nervous 
collapse come on him unawares and almost before he knows it he is in 
the clutches of nervous prostration. This violation of a very simple 



126 THE MAINTENANCE OF HEALTH. 

principle is so often seen among good business men who would smile 
at the statement of so self-evident a fact that it is impossible to main- 
tain a bank balance by continually writing checks and never making a- 
deposit. Yet such is the unreasonable and erroneous attitude which 
many of these assume towards the highly necessary physical and nerv- 
ous stock of energy. 



DOMESTIC HYGIENE. 

R. W. CON ANT, A.B., M.D. 

Among the physical needs of man, a healthful and convenient dwelling 
place stands next in importance to food and clothing. The first essen- 
tials of a dwelling should be plenty of pure air and sunlight. Neither 
appearance, convenience, nor expense should be allowed to interfere with 
these essentials, and yet they often do. 

Location. — This problem is much simpler in the country than in the 
city. The more thickly people dwell together, the more difficult it becomes 
to secure plenty of air and sunlight, to say nothing of freedom from dust, 
noise, and smells. In the city it is a great temptation to sacrifice these good 
things to considerations of accessibility, cheapness, or mere gregarious- 
ness. The very poor, especially, manifest an almost invincible propensity 
to crowd into the slums, where they pay as much for one or two noisome 
rooms in a tumble-down rookery on a filthy street as it would cost to rent a 
pretty little cottage in a suburb, with plenty of air, sunshine, and outlook. 
This soul and body destroying choice they persist in making, in the face 
of all advice, partly from ignorance and prejudice, mainly from the 
herding-together instinct, stronger even than in animals. And so the 
slums spread and fester like great plague-spots in the large cities — hot- 
beds of crime, misery, and infant mortality. 

Even in the better residence districts of a large city the conditions 
are none too good, especially for children. Where house is joined to 
house in solid rows, there is necessarily much room space which can never 
receive direct ventilation and sunshine. Worst of all, these dark rooms 
are usually the bedrooms, which most of all need abundant sun and air. 
So long as people will persist in packing into these unhygienic and often 
unsanitary dwellings,, the only thing which can be advised is to make the 
best of a bad case. This will be considered in detail under the subject 
of "Ventilation." 

The Suburbs. — If possible, own your own home, with a bit of ground 



FLATS VERSUS HOUSES. 127 

for a garden. In any case, live where there is open ground all around 
the house, so that no room shall be destitute of direct access to light and 
air. If you are obliged to rent, have a separate house or cottage if pos- 
sible. It is only a question of going out far enough, and if you are near 
good, rapid transportation, you are really as near to business as there is 
any need of being. On the lines of railway radiating from all our cities 
there are beautiful, healthful suburbs which can be reached in from twenty 
to forty minutes ; and what are a few minutes more in transit compared 
with the advantage of exchanging the noise and filth of the city every 
evening for the beautiful, peaceful country, especially in summer ? It is a 
strange perversion of taste which prefers staring solid blocks of houses 
and hot pavements to trees and lawns. 

Flats vs. Houses. — Much can be said in favor of each. Other things 
being equal, flats are usually cheaper, and if on the first or second floor, 
they save much stair-climbing — an important consideration for women 
or invalids. But the better air, view, and more sunshine are usually 
found on the top floors. On the other hand, they are poor places for 
rearing children, for reasons too obvious to need enumerating. But if 
a flat is to be rented, it should be one which has a maximum of wide 
courts, with good-sized rooms, well cleaned halls and alley, with prompt 
and sanitary disposal of ashes and garbage. Of course the plumbing, 
drainage, ventilation, heating, thickness of the walls and floors, wood- 
work, and cellar should be carefully inspected. It is also well to make 
some judicious inquiries of the tenants and neighbors. Especially critical 
should the inspection be if the building stands on "made land." Find 
out whether the land was "made" of garbage and refuse or of good soil. 

Skin Flats. — In some localities there has been a great deal of real 
estate speculation in "skin" flats and apartment buildings. A "skin" 
building is one which is put up as cheaply as possible, with a view to 
filling it with tenants and then selling quickly at a big profit before the 
building falls down. The judicious renter will be on the lookout for 
this class of flats and houses. Sometimes they are quite difficult of 
detection, the skimping and falsifying being confined to the parts of the 
buildings which are out of sight; but usually such buildings have a 
family resemblance instantly recognizable by the experienced renter. 
Almost always they present a tawdry prettiness, an excess of cheap col- 
ored glass and imitation woodwork, calculated to catch the eye of those 
who choose a dwelling place because of such adornments. 

The Best Way. — But by all odds the best way, when it is possible, 



128 THE MAINTENANCE OF HEALTH. 

is to decide first on your location and the rent you can afford to pay. 
Then watch the flats and houses being built in that locality, so that you 
may get an intimate knowledge of their construction, which will be 
impossible after they are finished. In fact, that is the only way in which 
you can be sure that any dwelling has a real drainpipe, actually connect- 
ing with the sewer through a perfectly sealed trap, and with ventilation 
to the roof. And yet that one thing is essential to the healthfulness of 
your home. Always rent a new flat, if possible, so as not to inherit 
other people's dirt or bugs. 

Of course you select your location with due regard to your family 
needs. If you are a business man, transportation must be reasonably 
quick, prompt, frequent, well lighted and heated; the station within easy 
walking distance, over good sidewalks, well lighted. If you have chil- 
dren of school age, a good school must be reasonably accessible. Fire 
and police protection must be adequate, which includes a fire plug and 
alarm box near your house, and a street which an engine can get through 
in any weather. You should investigate the range of prices at the neigh- 
boring groceries and markets, to learn if they are exorbitant ; also prices 
of gas, coal, and wood. If your wife must have domestic help, of course 
the matter of the local supply of assistants must be inquired into. 

The necessity of these precautions seems quite self-evident, and yet it 
is the neglect of them which often entails months of annoyance and loss, 
perhaps sickness and death. Either you or your wife must look after 
these things ; don't take the agent's word for it. He is there to rent 
the property and get his commission. Likewise, do not accept any 
verbal promises of changes or repairs to be made on the premises — have 
everything of any importance put in the lease. That document, by the 
way, should be read very carefully before you sign it. Some of them 
are tricky and outrageously unfair. 

The Country House. — Much of what has been said above applies 
equally to the choice of a house in the country, especially as regards sun- 
shine and air. But there are other features that are decidedly different. 
While you could scarcely avoid plenty of sun and air if you tried, you 
must plan very wisely for good water and effective drainage. If you are 
so fortunate as to be able to build your own house, there is no end of 
conveniences for you to plan. 

Of course the first thing is the selection of the site. The ideal site 
will be on ground somewhat elevated, in order to secure perfect drain- 
age and wide view, but that may not be possible. If obliged to build 



CELLAR WALLS. 129 

on the flat prairie, do not dig for a cellar more than three feet at most, 
and take every precaution to make it dry. 

Soil. — You cannot pay enough attention to the soil upon which the 
house is built. Most people think that if they avoid a marsh that they 
have a dry soil. Others are deceived by a sandy soil, and tell you that 
sand is one of the best drainage soils to be found. Yes; provided it is 
deep enough. But a foot or two of sand on a clay or rock base through 
which the water cannot drain is the most dangerous of all. If you are 
unfortunate enough to live on a damp soil, you would better move; for 
here is a list of the diseases which are connected with a cold or damp 
soil : all catarrhal affections of the lungs ; rheumatism ; neuralgia ; con- 
sumption; malarial fevers; typhoid; cholera; diphtheria; diarrhoea; 
and dysentery. 

If you have selected a site on the side of a hill, do not dig your cellar 
out so as to leave a cliff behind and the ground sloping to the front. 
But build a terrace in front so that you will have the same depth of earth 
all around the house. 

Dry the soil out as much as possible by effective drains. Put a 
cement floor over the bottom of the cellar, except where the drainpipes 
run. Put a board covering over the latter flush with the floor, so that 
you can get at them when necessary without tearing up the cement. See 
that no foul matter drains down from around the house; some people 
drain the surrounding land through their cellars. The effect of that 
is obviously bad. These points properly carried out will give you a dry 
cellar; one that can withstand perfectly the rainy or spring season. 

The Cellar Walls should be double to promote dryness. This may 
be accomplished in various ways — by building the cellar walls with 
hollow tiles, perforated brick, or artificial stone. The latter is especially 
good, since the internal cavities are so large that they connect freely; 
for the same reason, a house built entirely of artificial stone is best pro- 
tected against both cold and dampness. Of course the cavities should 
connect with the cellar and also with the open air at the roof, so that 
the heat of the furnace shall cause a free circulation of warm air through- 
out the walls. That will both dry and warm the house. 

On the outside the earth should be well banked up against the cellar 
walls at least two feet high, and to the same height the outside surface 
of the wall should be so well coated with tar, asphalt, or Portland cement 
as to be wholly impervious to water. Cellar windows should be put in 
with hinges and bolts so as to be opened easily for ventilation in dry 



130 THE MAINTENANCE OF HEALTH. 

weather. Nothing should be kept there which moulds or makes a musty 
smell. 

The House Walls may be of wood, brick or stone, natural or arti- 
ficial. Wood is usually the cheapest material, the coldest in winter and 
the hottest in summer. But whatever the material is, one thing is of 
prime importance — plenty of free air space all around the house between 
walls and plastering — and this space should communicate freely with the 
cellar. A furnace in the cellar, as usually managed, is one of the most 
wasteful ways of heating a house, for the reason that half of the heat 
is retained in the cellar, which becomes the warmest part. By making 
house walls practically double and connecting the middle space freely 
with the cellar, this wasted heat will circulate throughout the walls and 
add greatly to their warmth. 

The Roof. — Of course the roof should be water-tight — the object of 
a roof is to keep out moisture. There are several advantages of the 
sloping roof compared with the flat. Rain and snow run off rapidly, 
and the sun's heat in summer strikes only half the roof at a time except 
at midday. By opening the attic windows a circulation of air is secured 
which relieves the excessive heat of the upper rooms, and by closing 
them in bad weather an ideal playroom Is secured for the children. Also 
a large attic is a very convenient dry storeroom, or it may be partitioned 
off for extra rooms if needed later. 

Water Near the House is to be avoided. Stagnant water should 
never be allowed in any form or under any excuse. The chief objection 
is that stagnant water is the breeding place of mosquitoes and other 
insects, and. mosquitoes are not only an intolerable nuisance, but also 
the conveyors of dangerous disease germs. 

The disposal of drainage and sewage is the most difficult problem 
of all, especially if the ground is flat. One thing is sure, it must not be 
allowed to collect in pools of any kind to decompose into noxious gases, 
unless you want sickness in your home. Neither should it be run into 
the streams, making open sewers of them. 

Sewage. — The method adopted must depend a good deal upon cir- 
cumstances. If you have land under cultivation, all sewage should in 
some way be conveyed upon that land to act as a fertilizer, and especially 
all human excreta. The old-fashioned privy, as usually found in the 
country, is an abomination from every point of view and smell. By 
exercising a little intelligent care all that refuse, mixed promptly with 
clear soil, can be converted into a valuable fertilizer instead of a nuisance. 



THE RUBBISH PILE. 131 

But in winter the privy should be put out of commission entirely, and 
the earth house closet substituted. That will save a good deal of pneu- 
monia and rheumatism. 

Dry Earth Closet. — This is an application of the principle that the 
earth is the natural deodorizer of decomposing organic matter, to which 
class the human excrement belongs. If dry earth be added to manure 
it immediately becomes inoffensive. There are special forms of dry 
earth closet manufactured for sale. But where the use of them is neces- 
sary, a little care and ingenuity can make the necessary simple arrange- 
ment to apply one or two essentials. The earth must be dry, for the 
value of it depends upon its absorbent power, and wet earth has already 
absorbed about all that it can contain. Either dry clay or dry garden 
loam answers best. Sand is of no use whatever, as it is quartz, and that 
is not absorbent. The second essential is that a sufficient quantity of 
this good, dry earth be applied immediately after every use of the closet. 
No water or liquid must be poured into the receptacle, as this will make 
it offensive. The smaller the receptacle the better, as that will necessitate 
more frequent removal of the contents. For the destruction of any germs 
that may be in the faecal matter, a small quantity of quicklime will prove 
effective in a few minutes. The great difficulty in carrying out this prin- 
ciple is to get the right kind of earth and to dry it. 

Rain Water from the roof should not be allowed to run into the 
ground near the house, nor should it be allowed to stand even a few 
hours in any receptacle which can be entered by insects for the purpose 
of depositing their eggs. Looking out for this will save you much trouble 
later. Kitchen slops should not be thrown out to draw flies, but should 
go to fertilize the garden. By all means have a garden — two of them, 
vegetable and flower, one for you to dig and hoe in, and the other for 
your wife and children to raise beautiful flowers in. 

The Rubbish Pile. — Paper and all refuse which will burn should be 
so disposed of regularly in some remote corner, out of sight if possible. 
To the same rubbish pile should be conveyed all the ashes and litter of 
every kind, and the duty of keeping the premises thoroughly "picked up" 
is easy work for the children. It should not be made a task, but a matter 
of pride with them ; it should be understood to be their department, and 
any spending money they are to receive should depend upon the efficiency 
which they "show in that department. In this way ideas of industry, 
orderliness, of earning what they get, and of appreciating the value of 
money will be inculcated effectively from the start. 



1 32 THE MAINTENANCE OF HEALTH. 

Water Supply. — Next to the importance of getting all tainted water 
out of the house is the importance of bringing none in. This is almost 
as difficult, and is a point frequently overlooked. How many families 
take all their drinking water from a well in the center of a filthy barn- 
yard, toward which the ground slopes from all sides ! 

Generally speaking, the best water supply is a driven well of at least 
one hundred feet. But even that must be considered carefully with 
reference to the geological dip, for water will travel a long way under- 
ground between strata. Therefore, the well, however deep, should be 
located as far as possible from any privy, drain, sewer or barnyard, and 
should be on the "up" side of it. 

If the supply is taken from a spring, lake or river, that and all its 
tributaries and surroundings should be inspected with great care to 
make sure that there is no possibility of contamination by organic matter. 
If there is reason to doubt the purity of the drinking water, or if any 
epidemic breaks out in that neighborhood, see to it promptly that all the 
water drunk in your house is boiled half an hour and then allowed to 
drip through a gravity stone filter. After filtering, the water may be 
sealed up in Mason jars and set in the ice box to cool. That is not as 
poetic as the old oaken bucket that hung in the well, but it will cost less 
in doctor's bills. 

The dweller in the country has this great advantage over city people, 
that he can investigate and choose the source of his water supply. 
Although vast sums are spent on waterworks by all great cities, it is 
notorious that their supply is impure, often dangerously so. But the 
city dweller also holds his health in his own hands, for it is always within 
his power to boil the water and then filter it. Of the many filters on 
the market the simplest of all and also the most effective consists of two 
earthen jars, of which the upper one has a porous stone bottom through 
which the boiled water filters drop by drop. No family should be with- 
out one, for the germs of typhoid, cholera, and dysentery find an entrance 
into the body through impure water. 

The Grounds about the house should be judiciously variegated with 
trees and shrubbery. But neither should be allowed so near the house 
as to promote dampness or shut out sunshine and air. The house should 
have one or more wide verandas, screened in summer ; and with movable 
roofs which can be taken off in winter to let in the sunlight freely. Both 
city and country dwellings should face south, if possible, for that throws 
the kitchen, which needs the sun least, to the north side. For a like 



INTERIOR OF THE HOUSE. 133 

reason it is highly objectionable to have the kitchen on the west side of 
the house, for in summer the afternoon sun, added to the heat of the 
kitchen stove, makes the room a very inferno in which the suffering wife 
or domestic must prepare the evening meal. 

If there are any natural woods on your grounds, it is well to con- 
sider them in selecting the site. If the house is situated in the right 
direction from the woods, it will be protected from the worst blasts of 
winter; while in summer you will get the music of the leaves and the 
sweet scents of the forest. 

The Interior. — Even more than the exterior of the house, the inte- 
rior will be affected by considerations of expense, individual taste and 
special uses. But certain general principles may be laid down which 
should apply to all. Rooms should be large, light, and cheery, especially 
bedrooms. There is a too prevalent notion that the parlor must be a 
handsome room, while any dark closet will do for a bedroom. If pos- 
sible, every room should have two windows and on opposite sides, and 
a large closet. The minimum size of a room should be 1,000 cubic feet, 
say 12x9x9. 

Windows should be large, and both sashes easily moved, so that 
the upper may be lowered in warm weather to let out the hot air. Con- 
sequently the wire screens should be full length. Of course every door 
should be screened, with a spring to keep the screen door always closed. 
Every outside door should have a chain bolt, for safety at night and by 
day when the men are away. The front door should either be all plate 
glass, or should contain a glass window through which the person outside 
can be seen plainly. An electric light just outside the door, which can 
be turned on before opening, is also an excellent arrangement. A small 
wicket in the outer door, for speaking without opening, is wise. 

Stairways and Halls. — These should be wide, of easy tread, and as 
straight as can be. There should be two stairways at least, front and 
back. In the country, where land is comparatively cheap, no dwelling 
ought to be more than two stories high, for there is scarcely anything 
more injurious to women than frequent stair-climbing. For the same 
reason let there be an abundance of electric bells and speaking tubes 
and a dumb waiter. 

The Roof Garden. — The stairways to the attic and roof should be 
as easy as any in the house, not like ladders, as is usually the case. On 
the roof, even if it is a sloping roof, it is an excellent idea to have a 
platform to which the family can bring easy chairs and sit under an 



i 3 4 THE MAINTENANCE OF HEALTH. 

awning by day, or under the stars by night, whenever the weather is 
exceptionally sultry. That is about the only thing to be said in favor of 
a flat roof, that it can be turned into a veritable roof garden, far above 
heat, dust, noise, miasms, and insects; on a hot night when bedrooms 
are ovens, the roof will permit of refreshing, healthful slumber. The 
roof is appreciated by Orientals but neglected by Occidentals. 

Every Room in the house should be bright and cheery, no dark holes 
or catch-alls. If you have a flat roof and no attic, set aside one large, 
bright room as a storeroom for everything not in use which is worth 
saving. 

Don't concentrate all your efforts on beautifying the entrance and 
parlor at the expense of everything else. Let every room be good enough 
for the neighbors to see, and no room too good for the family to use. 
Of course all bedsteads and springs should be of metal throughout. Your 
domestic's room should be as pretty and attractive as your own, and 
she should be required to keep it just as neat. That is one of the secrets 
of inducing a domestic to stay with you, which is peculiarly difficult in 
the country. 

Hard Oiled Floors. If possible, have hardwood floors throughout 
the house, and never allow a carpet in your home, for both sanitary and 
financial reasons. 

House Cleaning. — This bugbear of housekeeping is immensely sim- 
plified by having no carpets to pull up and tack down. All that is neces- 
sary is to have all the rugs taken well away from the house to be beaten 
and swept, while the hardwood floors are gone over with a weak solution 
of green oil soap. First, however, the furniture should be cleaned with 
a brush, and the curtains taken down if it is time to have them laun- 
dered. Plush covered furniture and unnecessary draperies are highly 
objectionable on account of the dust which they hold. 

Painted walls are easiest cleaned, and are especially suitable therefore 
for the bath room and kitchen. Good paper on walls can be cleaned, but 
it is a tedious and not altogether satisfactory process; the best way is 
to repaper after stripping off the old. Calcimining cannot be cleaned, 
but must be done over. Tapestried walls offer the advantage of being 
easily cleaned, but of course they collect dust very quickly. Simplest 
and most sanitary of all is wood or metal paneling or enameled brick, 
which can be gone over easily and quickly with a damp cloth; or with 
an antiseptic, if there has been any contagious disease in the house. 

Prevention of Dust. — It is astonishing how much dust and fuzz will 



THE KITCHEN. 135 

accumulate in a house even in a single day. Much of it is unavoidable, 
but much can be avoided. Clothing worn in the street is brushed in 
the house, if brushed at all. This practice is both filthy and dangerous. 
Of course all outer garments should be thoroughly shaken and brushed 
outside the house every time they have been worn outdoors; otherwise 
they soon become perfect nests of every breed of germ life. 

Another prolific source of dust is the hot air pipes. They should be 
taken down every fall and cleaned. 

The Playhouse. — The best way to prevent dust in a house where 
there are children is to give them an entirely separate playroom. If 
your means and grounds will permit, build a playhouse for them in the 
yard, where they may be turned loose in bad weather with perfect safety, 
and allowed to raise all the noise and dust they want to. In pleasant 
weather the same little house may supply a welcome retreat from inter- 
ruption to an adult who wishes to read, write, or smoke. 

The Kitchen. — In these days of improvements the kitchen should 
be a veritable workshop of labor-saving devices, each in its place. # Fore- 
most of all, there should be a substitute for the coal range for summer 
use; the best is a gas range. If you cannot get gas, have one of the 
best gasoline cook stoves. The latter are made now so as to be perfectly 
safe and very convenient. Over either should be an ample hood connect- 
ing with the chimney, to carry off the odors of cooking. 

Then there is the ice box or refrigerator, which may be in the kitchen, 
or better, just outside, to escape the heat of the stove. There is much 
to be said in favor of each. But if there is much milk, cream, and butter 
to be cared for, neither should be used; instead there should be a dairy 
with running water in which everything of the kind can stand. A small 
imitation of this can be obtained by taking an ice box large enough to 
hold two or three hundredweight of ice, and plugging the outlet with a 
large spool. This will keep a few inches of ice water continually in the 
box, in which jars of milk and cream may stand. The ice should rest on 
crates, which will keep it out of the water. The ice box or refrigerator 
should be scrubbed thoroughly with hot water, or boiling water and 
borax, and then allowed to air for half an hour, "every time new ice is to 
be put in. 

Cleanliness. — Of course the kitchen should be spotlessly clean. As 
little grease as possible should be allowed to run down the sink drain, 
which should be flushed frequently with hot lye water. All bread, cake, 
and other food not in the ice box should be kept in close tin boxes out of 
reach of flies, ants, roaches, and mice. 



136 THE MAINTENANCE OF HEALTH. 

The Bath Room should be the best ventilated and best heated room 
in the house. All the plumbing should be open; a porcelain-lined iron 
tub of good length is the best and most durable. Have no wooden rim 
around it, and have it well tipped toward the outlet. Clean it with 
gasoline. 

Enameled brick in colors is the most sanitary, the handsomest, and 
most expensive covering for the floor, and for the walls to a height of 
at least five feet. If they are too expensive, substitute some hard finish 
which will wash, as cement or paint, and wash it frequently. All the 
outlet pipes in the bath room or elsewhere should be flushed with a solu- 
tion of copper sulphate, mercuric chloride, or some other good disin- 
fectant, at least once a month; in hot weather oftener. 

Every waste pipe in the bath room, and throughout the house, should 
be well trapped; and, so far as possible, all traps should be easily acces- 
sible and detachable for cleaning purposes. Not only should plumbing 
be open, but pipes of all kinds in the walls should not be plastered over 
but inclosed in channels with covers screwed on, permitting inspection 
and repair without damage to the surrounding walls, floors, etc. 

Usually the bath room is the coldest room in the house, being incon- 
veniently located at the end of some hall. That is a great mistake. In 
cold weather it should be so well warmed that those of low vitality can 
strip for a bath without danger of a chill. That will save sickness and 
promote cleanliness at the same time. Of course there should be every 
convenience in the bath room, including sprinkler and rough towels which 
will really scratch — no imitation. 

Ventilation. — The breathing of impure air, especially that which is 
deficient in oxygen, involves a rapid deterioration of the blood, the red 
corpuscles being impoverished, and the life current loaded with poison- 
ous matter which should be eliminated promptly. Therefore thorough 
ventilation, particularly in cold weather, is a matter of prime importance. 
Evidently, also, it is closely connected with the problem of heating. 

It would seem superfluous, in these times of general education, to 
urge the importance of ventilation, and yet how often the newspapers 
record deaths by asphyxiation during sleep. Either the gas jet goes 
out or the damper in the stovepipe is shut, and then the bedroom fills 
with gas because all windows are shut tight. Such deaths would be 
impossible if people ventilated their sleeping rooms at night as good 
health demands. 

This lack of ventilation is the chief cause of that much dreaded 



IMPURE AIR. 137 

disease, consumption, which is responsible for one-seventh of all deaths 
by disease. Consumption is almost wholly an impure air disease. If 
it has not reached a too advanced stage, it can always be cured by sleep- 
ing in the open air. 

Impurities of Air. — When a tightly closed room of ordinary size 
has been occupied for any length of time the air becomes loaded with 
impurities, partly from bodily exhalation and partly from the heat and 
the artificial light, besides the dust which may be stirred up by moving 
about. Of these impurities the most objectionable is carbon dioxide, 
a product of combustion, whether through the lungs, the pores, or the 
stove. It is not directly poisonous, for three to five hundredths of 
one per cent of outdoor air is usually carbon dioxide ; but in a close and 
occupied room this small amount is rapidly increased, taking the place 
of the vital oxygen and so becoming highly injurious. Inasmuch as 
oxygen is the only part of the air which we really use in respiration, as 
it is absolutely and continually essential to life, and as it constitutes only 
one-fifth of the volume of the purest air, it is evident that it takes very 
little impurity to impair the air seriously for breathing purposes. 

Tests. — There are several ways of proving chemically the presence 
of carbon dioxide, but it is hardly worth while to bother with them. 
You know well enough, without chemical test to prove it, that the air 
of a tightly closed and occupied room is sure to be foul. The nose test 
is ordinarily sufficient, for anyone of fairly good nasal perceptions, com- 
ing into such a room from outdoors, will immediately detect the impurity 
of the inside air. Yet people will crowd into theaters, concert halls, 
and other public rooms, where the air is, to a person of fine perceptions, 
simply horrible. And there they will sit from one to three hours, breath- 
ing each other's breath and exhalations ! 

The Problem of ventilating a public hall properly is extremely com- 
plex and expensive, but in the home there is no excuse for having bad 
air. The ideal method is to have some device for drawing off the impure 
air as fast as fresh warm air is introduced, or of introducing fresh cold 
air gradually from outdoors. There are several such methods which can 
be built into the house at the beginning. For ordinary purposes, how- 
ever, the natural leakage of air around windows and doors in very cold 
weather will be sufficient to keep the air of a house healthfully pure. As 
soon, however, as it gets milder outside, or as soon as a single room is 
shut off from the rest of the house, or as soon as an extra number of 
people are assembled in the house, it will become necessary to renew the 



138 THE MAINTENANCE OF HEALTH. 

air more rapidly. The difficulty is to do this without causing draughts, 
which are extremely dangerous to people who are sitting still. One of 
the best and simplest ways to raise the window a few inches and insert 
a board below, which shall exactly fill the space through which the sash 
has been raised. This will allow fresh air to work in gradually between 
the upper and lower sashes. At night the whole house, and particularly 
the bedrooms, should be well ventilated. If every bedroom door has 
either a transom or a chain-bolt, this can be done without danger of 
being surprised by burglars. 

Carbon Monoxide. — In all the above it is assumed that the heating 
apparatus is properly constructed and managed, so that it shall not add 
any carbon monoxide to the other impurities of the inside air. This 
chemical compound is a product of imperfect combustion, and is deadly 
poison. It is likely to be present whenever stoves or furnaces are im- 
properly fired, or when gas or oil stoves are burned in the room without 
a chimney to carry off the products of combustion. The latter, at the 
best, eat the oxygen out of the air at an alarming rate. 

Moisture is another troublesome constituent of air. If there is too 
little, the air passages become dry and subject to catarrh; if there is too 
much, the necessary exhalation through the pores is retarded. Modern 
dwellings are apt to err on the side of being too hot and dry. Dryness 
of the air in a room is easily remedied by setting a pan of water in a 
warm place, and all good furnaces have a receptacle for that purpose, 
which should be kept full. 

Heating. — It is hardly worth while to discuss the old-fashioned 
method of heating by stoves — the objectionable features are so evident 
that stoves have, for the most part, long since been discarded in favor of 
furnaces of various kinds. Wherever they are still in use, however, great 
care must be exercised to prevent any chance of their pouring forth the 
deadly carbon monoxide, especially at night when the family is asleep. The 
only thing to be said in their favor is that little of the heat produced is lost. 

Furnaces, on the other hand, are usually wasteful because a large 
part of their heat is radiated into the cellar, which is the warmest part 
of the house. This can be obviated considerably by having the furnace 
and warm air pipes thickly covered with asbestos to check radiation; 
also by having the cellar connect freely with the air space between double 
walls all around the house — as explained under "Construction." Also, 
furnaces make a good deal of dust, which flies up the flues unless care is 
taken to open the dust damper before shaking down. 



FIREPLACES AND GRATES. 139 

The furnace may be used — with a hot fire and all the drafts open — 
as a crematory for garbage which cannot be disposed of otherwise. 

Of course the same loss of heat occurs in furnaces which heat boilers 
for hot water or steam heating, but they have the advantage of not 
carrying dust directly into the rooms. On the other hand, they lack 
the advantage of introducing warm air fresh from outdoors, as the warm 
air furnace does ; and it takes longer to get up steam or hot water than 
warm air, which is a consideration in bitter cold mornings. Besides 
that, unless you have a double system of steam pipes, to bring and carry 
off steam, you are likely to be annoyed by cold radiators and by the 
banging of the steam in the pipes. Hot water heat is more quickly 
obtained but less intense. 

These objections may be overcome by having the steam radiators in 
the cellar instead of in each room, and passing air over and through 
them directly from outdoors, and then through pipes to each room. 
Sometimes the air is strained of dust by being passed through coarse 
cloth. This combination of steam and warm air is frequently used in 
large buildings, and has the advantages of both systems, of both direct 
and indirect radiation. But any system of heating should be combined 
with a system of effective ventilation, to carry off the impure air. 

Whatever method of heating is employed, it will be found that in time 
the heat will shrink the woodwork badly, unless the latter had been very 
thoroughly seasoned before building. So far as possible, the cracks and 
crevices thus formed should be filled up, either with putty or cement or 
slivers of wood; otherwise they become permanent dust holes and germ 
nests. 

Start Early. — But whatever the mode of heating there should be 
no neglect of one thing. In cold weather it should be the duty of some 
one who is reliable to start the furnace so early that the house will be com- 
fortably warm when it is time for the family to rise. Much sickness, 
discomfort, and lying abed are due to the foolish practice of having an 
ice cold house just at the time when warmth is most needed. If the 
dampers are so arranged as to be worked by chains from the first or 
second floor, it is a slight matter for some one to attend to them very 
early and then go back to bed for another nap. 

Fireplaces and Grates. — The first is the real thing, the second is 
only a feeble imitation. Still, a grate full of glowing coals on a cold night 
is much better than a blank wall. Both, however, are sanitary and 
^esthetic, rather than practical heating- devices. . What can be finer when 



i 4 o THE MAINTENANCE OF HEALTH. 

the wind is howling outside like a banshee, and the snow drifting against 
the windows, than to sit snug before a roaring fireplace, either in solitary 
meditation, or with the family grouped around, looking for pictures in 
the glowing embers ? Of course the fireplace is the most wasteful method 
of all for heating a room, but its advantages quite justify the extrava- 
gance for those who can afford it. 

Regulation of Temperature. — Few people can agree exactly as to the 
most desirable indoor temperature in winter. In the first place, a tempera- 
ture which seems just right to a person sitting still and working with his 
brain seems suffocating to one who is moving about and doing manual 
work. Seventy degrees Fahrenheit is generally the lowest which the 
former can bear without risk, and that does not mean 70 degrees at his 
head but at his feet. People differ also in respect to vitality, either from 
difference in age or constitution, and what is just right for one is just 
wrong for another. Therefore no rule can be laid down except the very 
general one, that the temperature of the house should be kept as low as 
the members of the family can stand it without taking cold. If there is 
anyone in the house who, for any reason, must have a higher tempera- 
ture, that person should have a warm room shut off from the rest. 

The temperature of the house should not be continually fluctuating 
between hot and cold, according as some one impulsively booms the 
furnace or throws open a window. Individual feelings are a poor guide. 
The temperature should be kept as near as possible to some fixed point 
on the thermometer — usually 70 degrees is best — by some one whose 
regular duty it shall be to attend to it. 

Automatic Regulation. — Better still is it to have automatic regu- 
lators such as are installed now in many schools, hotels, and some private 
houses. These work by electric contact, so that when the temperature 
reaches the degree for which the regulator has been set, the heat supply 
for that room is diminished automatically until the temperature falls 
below that point. 

In hot weather the opposite problem needs to be solved. It is not 
very creditable to our inventive geniuses that they have not yet devised 
any practical method of cooling houses cheaply in summer. Some day, 
doubtless, it will be done. It would not seem that the difficulties were 
insurmountable in the way of passing ice cold water through the pipes 
and radiators through which steam is forced in winter. Even now that 
is done in larger cooling plants, but for private dwellings the expense 
is prohibitive. 



LIGHTING. 141 

As matters stand now, little can be done toward cooling the interior 
of most private houses besides keeping the windows down. The sense- 
less modern custom, especially in cities, of building houses with no pro j 
tection from the glare of the midsummer sun beyond a scant roller shade, 
leaves the inhabitants at the mercy of the heat. But there is an excellent 
device in an outside shutter which is so hinged that it can be opened 
either sideways in the usual manner or vertically, i. e., open at the bottom 
with a hinge at the top. In the latter position it is equivalent to an 
awning, only better, for the slats may be opened for either view or breeze. 

If the heat becomes dangerously intense, resort to the Hindu device 
of wringing out towels and sheets in cold water and hanging them in 
the windows and doorways. The evaporation will lower the stifling 
temperature a little when a little means a good deal. 

Lighting. — The best light is that from the sun, which tries the eyes 
least and is deadly to all disease germs. Therefore every building and 
dwelling should have a maximum of window surface, especially in the 
city ; and, when possible, two windows opposite each other in each room. 
Neither should these be rendered valueless by piling shades, curtains, 
and draperies over them, as is sometimes done to the extent of three 
layers. The sunlight should enter every room in the house which it 
can reach, and the bedrooms especially should be thrown open to it at 
the right time every day. 

But modern life peculiarly requires artificial light, and many are so 
unfortunate as to be obliged to use it all day at their work. Of all the 
artificial kinds the worst is the arc light, with its intense white glare and 
frequent jumping. 

A good kerosene lamp with round or duplex wick and well cared 
for gives the mellowest and cheapest light. If the oil is bought in five 
gallon lots or by the barrel the cost per hour is a small fraction of a 
cent. Lamps, however, give out a great deal of heat, and are therefore 
unsuitable for warm weather. 

Gas is good or bad, according as it is used. In the first place, it is 
the easiest thing in the world to run up enormous gas bills, especially 
in a large house where several people are careless about allowing it to 
burn. But if each room is provided with a "by-pass" on the gas fixture, 
and if each person will be careful to pull the by-pass as soon as the light 
is no longer needed, the bills can be kept within bounds. There are two 
places, at least, where a light should burn low all night — the hall and 
the bath room. 



142 THE MAINTENANCE OF HEALTH. 

The ordinary gas jet is wasteful, heating, insanitary, and unclean. 
A large part of the gas is not consumed at all, but is deposited as soot 
on the ceiling, or floats in the air until deposited elsewhere. Not only is 
the oxygen burned out of the air rapidly, but also the air is filled with 
impurities, so that the effect is soon apparent to the senses, and later 
appears in drowsiness and headache. 

Incandescent Gas Light. — But great improvements have been made 
in gas lighting, especially by the use of mantles and various forms of 
the Bunsen burner. These devices are now brought to such a point of 
perfecti6n that a beautiful, steady light, flooding the room with a mellow 
radiance, may be obtained from a jet of gas so fine that it issues through 
a mere pinhole. Of course every part of it is consumed. The by-pass 
can be attached to these also, so that the mere pulling of a small chain 
shuts the light almost off or turns it on full strength. This variety of 
gas light is extremely cheap and satisfactory. The only objection which 
can be urged against it is that it heats up the room in warm weather. 

The Incandescent Electric. — One argument in- favor of the electric 
bulb is that it does not heat the air appreciably and does not vitiate it. 
Also, the light is easily turned on and off, and on an insulated wire cord 
the bulb may be hung anywhere in the room. It is still the most expen- 
sive light, but it is being cheapened and perfected all the time. One 
of the latest improvements has obviated a decided objection — that there 
was no choice between darkness and brilliant illumination. Now the 
"Hylo" device enables one, by a turn of the wrist, to reduce the light to 
a one candle power. The so-called 16 candle power bulb is usually a 
third less, so that several are needed to make a good reading light. 
Defective insulation and crossing of wires have been the cause of many 
destructive fires. 

Acetylene Light. — This is familiar to the public in the form of the 
acetylene bicycle lamp. The light is intensely brilliant, casting very 
black shadows, with great evolution of heat. The chief point in its 
favor is that it is one of the cheapest illuminants, but there is a public 
prejudice against using it on account of its bad record of explosions. 
The manufacturers insist, however, that they have now brought it to 
such a point of perfection that it is absolutely safe. 

Gasoline Generators. — The most familiar form of these are the 
flare lights suspended over hucksters' stalls, but the evolution of heat by 
the blue hydrogen flame is out of all proportion to the light. This may 
be obviated by using gasoline with an incandescent mantle, as is done 



POSITION OF LIGHT. 143 

in street lamps where gas is not obtainable. The light thus produced is 
very bright, about the same as from the best gas mantles. Of course 
gasoline must always be handled with care, and never exposed in the 
same room with a light or fire of any kind. 

For household use it is better not to depend on any one illuminant 
exclusively, lest it may fail unexpectedly and leave you in the dark. 

Position of Light. — Inasmuch as artificial light must be used largely, 
it is of the highest importance that the light should be so placed as to 
have the least injurious effect on the eyes. This may be accomplished 
in different ways, and each has its merits. In case the light is strong 
and brilliant, as incandescent gas or electricity, it should be up near the 
ceiling, and the direct rays should be softened by ground glass or porce- 
lain globes. Then the room will be filled with a diffused radiance much 
like sunshine. 

But even this may be trying to weak eyes, in which case a feebler 
light should be used, set on a table near the book or work and covered 
with an opaque reflector which will throw all the light on a circumscribed 
area, leaving the rest of the room in dim light. 

If a lamp is used it should be well shaded, or else the reader's sight 
should be protected by an eye shade or by turning his back to the light. 
The latter is preferable, when possible, for the reason that it compels 
him to hold up his head and receive the light over one shoulder. Chil- 
dren, especially, are prone to hang over their books, which interferes 
with the free circulation of blood through the neck and brain, and, worst 
of all, congests the eyes. The eyesight of school children in general 
grows alarmingly worse, and every care should be taken to prevent any 
congestion or strain in that part. 



EFFECTS OF CLIMATE ON HEALTH. 

The functions of the liver and of the skin are particularly active in 
warm climates; the digestive processes are not vigorous; in the dry 
season the nervous system is excited, and in the wet season, depressed. 
In cold climates the digestion is vigorous; the nervous system sluggish; 
the muscular development is great, and life is generally more prolonged 
than in any other climate. Temperate climates, on the whole, are most 
healthful; there is no strain on the liver, the digestive organs, or the 
skin, as is seen in warm climates; nor upon the lungs and kidneys, as 



144 THE MAINTENANCE OF HEALTH. 

is the case in cold and damp climates. The cool, temperate climates 
are the most healthful of all. 

Acclimatization. — This is the process by which man adapts himself 
to new climatic conditions. He undergoes certain changes by which 
he can thrive and maintain health in a climate to which he is not indige- 
nous. The great reason why inhabitants of a colder clime who move to 
the tropics suffer so severely is because they are not so careful of their 
health as are the natives. It does not appear clearly proven that one 
can become so adapted to a climate as to become immune to disease. 
There is no length of residence that will prevent one from taking 
malaria in regions where that poison exists. Even the natives cannot 
successfully withstand it. While the natives of the tropics are able 
to bear the intense heat of the sun to an almost incredible degree, a 
stranger can never, even after years of residence, become inured to its 
effects. Much of the unhealthful state of tropical regions is due more 
to a lack of sanitary conditions than from the effects of the climate proper. 

Diseases Due to Climate. — There are certain diseases which may 
be justly regarded as climatic. Malaria, yellow fever, inflammation 
of the liver, and dysentery certainly may be so considered. Pulmonary 
affections, such as bronchitis, pneumonia, consumption, are unknown 
in some regions and are very prevalent in the temperate climates. 
Sunstroke and frostbite are, of course, due to exposure to the extremes 
of temperature. Generally it may be said that the majority of the 
infectious diseases, such as cholera, yellow fever, etc., are to be found 
most frequently in hot climates; malaria and its chain of attendant 
diseases are due to a poisonous soil. Liver troubles, dysentery, and 
certain forms of anaemia are characteristically tropical diseases, while 
lung affections are most frequent in damp climates. 



BOOK II. 

THE CAUSATION AND PREVENTION 
OF DISEASE. 

GORDON LINDSAY, Ph.G., B.S., M.D. 

Bellevue Medical College, New York ; Staff of Bellevue and Allied Medical Hospitals. 

It might be supposed, on first thought, that the "Preservation of 
Health" and the "Prevention of Disease" are synonymous terms; but a 
glance at the topics which are discussed in this and the preceding articles 
is the surest and speediest means of realizing that, while they are inti- 
mately connected in results, they are widely different in methods. 
They are co-equal divisions of the great branch of Hygiene. In the one 
case we conform to those rules of hygiene by which the body and the 
mind are brought into a more vigorous state of health ; in the other case 
we endeavor to ascertain the causes of disease and to remove or overcome 
them. 

It is now proposed to gather up the different conditions and causes 
which bring about disease, and to consider how they may be successfully 
attacked in our daily living. 

Causation of Disease in General. — The two great classes into which 
the causes of disease are divided are: the predisposing causes and the 
exciting causes. By predisposing causes to disease are meant all of those 
conditions which so change the state of health of a person as to make 
him subject to, or predisposed to, contract a certain disease to the influ- 
ence of which he happens at that particular time to be exposed. The 
exciting causes to disease are those which immediately excite or impart a 
disease. Suppose, for illustration, that twenty people are breathing the 
same air, which is laden, as nearly all air is, more or less, with germs of 
disease. One of the number is stricken with disease and the other nine- 
teen are not at all infected. It is ascertained on inquiry that the one 
who contracts the disease has been suffering severe privation of food 
and clothing. This privation has so deranged the health and weakened 
the vitality, that the system became a suitable soil, as it were, for the 
growth of the disease as soon as its germs were implanted therein. The 
privation endured is clearly the predisposing cause; and the germs are 
the exciting cause. Those who were not affected, although they had 
breathed these same germs of disease at the same time, had by regular 



146 CAUSATION AND PREVENTION OF DISEASE. 

living and observation of the laws of hygiene so fortified themselves 
against the attacks that there were no predisposing causes to the disease. 
There are some families that are remarkable for "catching" all the dis- 
eases to which they are exposed. The predisposing causes to disease, as 
hereinafter considered in detail, are the points for such to consider, for 
along those lines lie their avenues of escape. One of the most marked 
peculiarities of predisposition to disease is the fact that a number of 
persons in the same place, at the same time, and under exactly the same 
conditions, may be exposed to the effect of cold, to the extent of con- 
tracting a chill. Now, so far as the immediate effect of the cold is con- 
cerned, it acts on all of them alike. That is, it chills the surface of the 
body, the pores of the skin contract and close up, and internal congestion 
takes place. But some of the number experience no ill effects, one of 
them is attacked by bronchitis, another with pneumonia, another with 
inflammation of the bowels, and a fourth with apoplexy. Those who 
were not affected were not predisposed to disease. The others were 
attacked according to the part of the body that was most affected by 
the congestion. To more clearly understand these and similar instances, 
it is necessary to take up the predisposing causes in detail. 

Predisposing Causes to Disease. — The chief of these are : age, sex, 
heredity, hygienic conditions, and climate. 

Age. — The influence of age is very considerable. Childhood and 
youth, being the period of growth and excessive repair, and old age, 
the period of decay and excessive waste, are the stages of life most sus- 
ceptible to disease. Maturity, or middle life, the period of equality of 
waste and repair, is comparatively free from disease. Then, the diseases 
of childhood are very different from those which affect declining years. 
The first and second teething periods and puberty are the critical times 
of childhood and youth. Among the diseases of these periods are acute 
catarrhal inflammation, especially of the alimentary tract, convulsions, 
acute tuberculosis, rickets, measles, scarlatina, whooping cough. To 
these may be added those diseases resulting from unsanitary conditions 
of living, such as overcrowding, bad water and air, privation, etc., con- 
tracted chiefly because their powers of resistance are very low at this age. 
At puberty the mental, moral, and physical conditions are easily dis- 
turbed and hysteria, epilepsy, lung affections, chorea, or St. Vitus's dance, 
and rheumatic and scrofulous diseases are common. Adults rarely suffer 
from the diseases peculiar to childhood, because the attack in their earlier 
years renders them insusceptible, more or less, in later years. 



PREDISPOSING CAUSES OF DISEASE. 147 

Practically the only diseases to which persons of mature age may be 
said to be liable are those of occupation. 

During decline, those diseases which are dependent upon the degen- 
eration of tissues are common. It is difficult to say, however, when old 
age sets in, for many a man at forty is older than another at sixty, so 
far as decline and waste are concerned. Characteristic diseases of this 
period are : diseases of large organs, loss of power of the stomach, liver, 
kidneys, and degeneration of the brain, nervous system, and its functions. 

Sex. — Apart from those diseases which are obviously peculiar to the 
sexes, it is a matter of observation and record that women are more 
subject to hysteria and allied diseases, ulceration of the stomach, neu- 
ralgia, and goitre, than are men; and that men are more susceptible to 
epilepsy, tetanus or lockjaw, goat, diabetes, locomotor ataxia, vesical or 
bladder trouble, and acute affections of the lungs. 

Heredity. — Heredity, as a predisposing cause of disease, manifests 
itself in the variations of robustness, or of constitutional strength to 
resist unfavorable influences. It is usually observable as a family trait, 
although a marked difference in these respects may be noticeable between 
the children, according as this one favors the father and that one the 
mother. It is in this connection that family history plays such an impor- 
tant part in matters of hygiene. It must be remembered that a sound 
constitution does not mean great physical size and muscular strength. 
We often find under the "goodly outside" a weak constitution, ill-fitted 
to withstand the attacks of disease; and, on the other hand, in those of 
delicate, clear skin and slender build, are frequently stored up veritable 
surprises of large vitality and abundant force to cope with disease. 

Very erroneous ideas prevail concerning the transmission of disease 
from parent to children. It was, until very recently, firmly believed that 
if one of the parents died from consumption, cancer, or a similar disease, 
the children were marked, and that the same, fate awaited them in spite 
of all that could be done for them. In the reaction that has set in against 
that belief, there are some extremists who quite as firmly believe that 
heredity has absolutely nothing of influence in these matters. The safe 
and sane belief is that if a parent has been afflicted in that way, the 
children, while carrying no actual taint of the disease, are predisposed 
to the disease and that it is necessary that they especially observe a careful 
mode of life in order to fortify themselves in that particular direction. 
It is not only arrant folly but positively suicidal for a man or woman to 
allow the knowledge of the existence of such so-called hereditary diseases 



148 CAUSATION AXD PREVENTION OF DISEASE. 

in the family to cause the relinquishing of hope, or of interest in life. 
There are some who are haunted by such knowledge, and who seem to 
be standing on the brink of the grave, in momentary expectation of the 
appearance of the well-studied symptoms. Many a life has been de- 
stroyed by such anticipation. Every pain or slight ache is construed by 
them as being the manifestation of the long-expected infirmity, and they 
thus drag out a life devoid of pleasure or of purpose. It is not necessary 
for such persons to go beyond the facts and figures of insurance com- 
panies for assurance. It is clearly proved by years of record that of 
those persons who have been refused as being unsatisfactory risks on 
account of the death of one or both parents by such diseases, not ten 
per cent are ever affected by them. Those are cold figures, made with- 
out favor or prejudice, and as such should be clear and convincing proof 
that their fears are groundless. A rigid observance of the laws of 
health will remove them beyond the influence of these predisposing 
causes. 

Hygienic Conditions. — Insanitary conditions of living are the direct 
cause of many persons, otherwise well started in life, acquiring a marked 
predisposition to disease. Among these conditions are overcrowding, 
privation, and fatigue, which, unfortunately, too often are the ills borne 
by the poorer classes. Overcrowding, with its lack of fresh air, and its 
poor ventilation to remove the foul air, works out its slow poisonous 
effects upon the body. Privation lowers the strength and tone of the 
system. Fatigue wastes the tissues beyond the bodily power of repair 
and is a constant drain upon the vitality. Intemperance in food and in 
the use of alcohol are not only in themselves predisposing but exciting 
causes to disease. Impure drinking water leads to a special predisposi- 
tion to diarrhoea, cholera, and fevers. Insufficient clothing exposes to 
the chill and so predisposes to that exciting cause of so many ills. Occu- 
pation, whether by overcrowding in ill-ventilated workrooms or by the 
breathing of irritant gases, is often both a predisposing and exciting 
cause of lung and other affections. Climate, with all of its variations 
and extremes, is both predisposing and exciting. 

Exciting Causes cf Disease. — The exciting causes to disease are 
divided into four classes : mechanical, physical, chemical, and vital. They 
admit also of a broad division into external and internal causes. 

Mechanical Causes. — These produce results that chiefly concern the 
surgeon. Among them are external violence, which produces bruises, 
cuts, wounds, fractures, shock, and mutilation. The internal exciting 



CONTAGION. 149 

causes to disease include the stopping of passages by gallstones, by stone 
in the bladder, by abscess, inflammation, and by foreign growth. These, 
perhaps, may be considered as lying beyond the domain of hygiene, as 
they are usually the result of morbid conditions. 

Physical Exciting Causes. — These include extremes of heat and cold, 
which produce respectively sunstroke and frostbite; but they do not 
include climatic effect of the more moderate temperatures. 

Chemical Exciting Causes. — Under this head are grouped the poisons, 
whether the mineral and vegetable poisons introduced into the body, or 
the internal poisons which form in the body. There are also snakebite, 
alcohol, putrid and decayed food poisons, commonly known as ptomaines, 
all of which may be regarded as being introduced into the body, and 
come under the head of the external poisons. In addition there is the 
poisoning by accumulations of effete matter in the system. The com- 
monest of these is the poisoning by the absorption of faecal matter, 
which is the great ill effect of constipation, and -the absorption of uric 
acid from the kidneys causing rheumatism and uraemia. Uncleanliness 
of the skin prevents the elimination of matter by that channel, and the 
consequent driving back of these poisons into the system. 

Vital Exciting Causes. — Among these are the parasites that cause 
parasitic diseases, contagia of other specific diseases, and malarial poison. 
They are known as vital causes because most of these media for con- 
veying disease are living forms ; the very great probability is that all are. 

Contagion. — The distinction which was formerly made between 
contagion and infection is responsible for many erroneous notions as to 
the way in which dangerous diseases are communicated. It was held 
that contagious diseases could be contracted only by actual touching of 
the person affected; and that infectious diseases were communicated 
without actual contact. This distinction lost sight of the carrying power 
of clothing and other similar means of conveying disease. In this way 
much greater risk of exposure to disease was taken and the spread of 
disease increased. 

Contagion is properly the property or the process by which disease 
is communicated from one part of a diseased body to another part of 
the same or to another body. The Latin name of contagium (plural 
contagia) has been given to whatever does this. The means of conta- 
gion is contact; and this contact may be immediate, by actual touch, or 
it may be by mediate contact, as through clothing, discharges from the 
body or by germs of disease. 



150 CAUSATION AND PREVENTION OF DISEASE. 

Nature of the Contagia. — Modern scientific research is tending to 
show with more and more certainty that all contagia of disease must con- 
tain in itself, or be included in, some form of living organism capable of 
multiplying itself rapidly. This is the basis of the germ theory of dis- 
ease, and the living forms go by the name of micro-organisms, or gen- 
erally of bacteria. Very valuable contributions to this phase of the 
spread of disease have been made by Koch, the German scientist. He 
has laid down the following conditions as being necessary to demonstrate 
that a particular form of micro-organism is beyond doubt the cause of 
a certain disease: — 

1. The organism must be found in the tissues or fluids of the person 
suffering from the disease. 

2. It must be taken from the body and recognized with absolute 
certainty by a series of experiments and examination by cultivation. 

3. It must be injected by inoculation into the bodies of animals to 
clearly prove that it is capable of producing the same disease in them. 

4. The organisms must be proved to be present in the last named 
case as laid down in the first condition mentioned. 

Mace, the scientist, suggests that two more conditions be laid down 
as necessary to indisputable proof, viz. : — 

5. That the organism be not found in other diseased conditions. 

6. That the organism be not one of the known harmless forms which 
are found in the skin and the intestines both in health and disease. 

These conditions have been met in so many diseases that the theory 
is accepted as true in all cases, and additional research is constantly con- 
tributing more proof. The facts regarding the nature of the contagia, so 
far as known, may be briefly laid down in the following points, to be 
borne in mind : — 

The contagium of any one specific disease, on entering the system, 
produces that disease and none other; the virus of diphtheria produces 
diphtheria and not smallpox. 

When the contagium has entered the body it multiplies in the body 
indefinitely. 

Bacteria. — The bacteria which produce disease are divided into two 
classes : first, those which live on dead animal or vegetable matter, which 
cause decay or fermentation, and are not able to enter the tissues of living 
plants or animals, and are called Saprophytes; second, those which live 
within or upon the tissues of living plants and animals, some without 
harmful effects, and others producing disease. These are called Parasites. 



BACTERIA. 151 

The great group of bacteria is divided, on the basis of their shape, 
into two large families. The first family includes all those which are 
spherical, cube-shaped, united in chains, and those which occur in irreg- 
ular masses. To this family the name of Coccaceae is given. The second 
family includes those which are in the form of rods or cylinders, and 
grouped into genera according as the rods are straight or nearly so, 
curved or spiral of several turns, those with a gelatine covering, and those 
which are long and thread-like. 

Cholera. — The bacterium which produces cholera {Spirillum chol- 
erae) is commonly known by the name of the "comma bacillus," as it 
resembles the comma in shape. 

Diphtheria. — It is generally conceded that the germ which produces 
diphtheria is the Bacillus diphtheriae, although several forms of bacteria 
are found in the false membrane in the throat. 

Mode of Entrance into the Body. — The poison of disease enters the 
body in one of the following four ways : — 

1. By coming in contact with the broken surface of the skin or 
mucous membrane. 

2. By coming in contact with the unbroken surface of the skin or 
mucous membrane. 

3. By inhalation of the air. 

4. By food and water taken in the acts of eating and drinking. 
Action within the Body. — Immediately after the poison has entered 

the body, there follows a period of longer or shorter duration during 
which the poison is inactive. This is known as the period of incubation, 
when the symptoms of the disease develop. Then follows the period of 
invasion, during which the symptoms manifest themselves. The period 
of eruption comes next, and lastly the period of decline. 

The period of incubation varies greatly, not only in different diseases 
but in different cases of the same disease. It may vary from not less 
than a month or even a year, as in the case of hydrophobia, to a very few 
hours. 

During the periods of invasion and eruption, the poison is diffused 
throughout the organs of the whole body; the lymphatic glands throw 
the poison into the blood in constitutional diseases and into the organs in 
local diseases, and the contagium multiplies itself to an enormous degree. 

In the stage of decline of the disease, or recovery, there are indica- 
tions that the poison has run itself out, either by reason of there being 
no more material favorable to its growth upon which it may act, or by 



152 CAUSATION AND PREVENTION OF DISEASE. 

the formation of chemical substances in the body which prevent it from 
doing so; or because the stamina, or resisting power of the body, has 
been great enough to overcome the attacks of the poison. The effect, 
generally, of an attack of a disease is to render the person immune to 
future attacks of the same disease. 

Exit from the Body. — During the course of a disease, the contagium 
has increased and is present in the body in enormous quantities. Its 
mode of exit largely depends upon the part affected. In typhoid and 
cholera, where the seat of the disease is the intestine, the contagium is 
voided in the stool and urine. In smallpox, the seat of the disease is in 
the pustules on the surface of the body, so the poison passes off in the 
scales of skin and matter which falls from the body of the patient. In 
scarlatina, the passage is in the same way as in smallpox, and the process 
of peeling of the skin is known as desquamation. Contagious throat and 
lung diseases void the poison in the discharges of sputum and phlegm. 

Existence Outside of the Body. — The behavior of the poison on reach- 
ing the outer air is very different in different diseases. Some of the 
poison, as that of typhus, loses its power of infection in the presence of 
air; probably the oxygen of the air destroys it. The poison of other 
diseases, such as smallpox and scarlatina, lives for a long time, is carried 
about in clothing, and remains in a dormant condition for a long period, 
ready to break out into virulent activity as soon as the conditions of its 
development are favorable. This difference of behavior of the poisons 
of different diseases is of the utmost importance to remember in the 
prevention of disease. 

Modes of Transmission. — If the poison has been passed from the 
body in the faeces, it is most likely that these will eventually contaminate 
the water supply or food supply, and thus food and water become one of 
the most frequent modes of transmission of such poison. Other poisons 
which pass off into the air are inhaled. So that the most common means 
of transmitting disease is by water, food, and the air. 

GENERAL RULES FOR THE PREVENTION OF 
INFECTIOUS DISEASES. 

i. Place the patient as far as possible away from the other mem- 
bers of the family. If it is possible, give him the top floor and keep 
that for him and his attendant exclusively. If the home does not afford 
this accommodation with comfort, remove the patient to a hospital. This 



PREVENTION OE INFECTIOUS DISEASES. 153 

is a duty to the other members of the family and also to the public health. 
No sentimental or other feelings should be permitted to interfere with 
this plain and clear duty to the family and the patient, as well as to the 
community. 

2. Those who nurse the patient must be persons who have already 
had the disease, if such can be procured. They should remain with the 
patient and not come in contact with the other members of the family. 
Should they do so they should first wash in water in which some disin- 
fectant has been placed, such as carbolic soap or Condy's Fluid. They 
must avoid breathing the patient's breath. Nurses must have exercise 
in the open air regularly, first washing and changing the clothing. The 
latter should be of cotton, which does not afford a lodging place for 
germs and contagion, as do woolen materials. 

3. Keep visitors out of the rooms. Those that are admitted should 
conform to the sections of the second rule applying to nurses. 

4. The contents of wardrobes, closets, etc., in the sick room must 
be removed at the time of occupancy. No bed hangings, lace curtains, 
carpets or rugs, and similar lodging places for poisons and infection 
should be permitted to remain in the room. Only such furniture as is 
absolutely necessary, and that is very little, should be retained. 

5. Ventilate the room by partly open windows, by opening the 
chimney draft, and, in cold weather, by keeping a grate fire going, if 
possible, even though the house is otherwise heated. The open fire is 
the best ventilator in the house. 

6. Keep the door closed, and hang over it a sheet dipped frequently 
in a disinfectant solution such as Condy's Fluid, chloride of lime, carbolic 
acid, or corrosive sublimate. 

7. All the discharges from the patient, the sputum, vomit, faeces, 
and urine, should be received in a disinfected vessel, and another quantity 
of the disinfectant be added to the vessel before carrying the contents to 
be emptied into the closet, or to be burned or buried. 

8. All pieces of cotton or linen used for wiping the nose or mouth, 
or for receiving the sputum, should be at once burned. They must not 
be allowed to accumulate or lie around. 

9. "When the sheets or the sleeping garments of the patient are 
changed, each article, before being taken from the room, should be dipped 
in a disinfecting solution; let them remain in this for an hour and then 
boil them at once. 

10. Keep the patient and his bed scrupulously clean. 



154 CAUSATION AND PREVENTION OF DISEASE. 

ii. Let the patient have one set of dishes, spoons, and drinking 
glasses, for his exclusive use. See that his dishes are used only by himself 
and not by others, and that he does not use the dishes of others. All dishes 
used by the patient should be placed in a disinfecting solution before 
removal from the room, and then washed in boiling water. 

12. All scraps, and unfinished or untasted food, should be treated 
in the same manner as are the discharges from his body — disinfected and 
thrown at once into the sewer, burned, or deeply buried. No other 
member of the family should eat them. 

13. After recovery, the bedding, the clothes of the patient and all 
of the furniture and entire contents of the room are to be instantly and 
thoroughly disinfected by the methods and according to the directions 
given on page 163. 

SPECIAL PREVENTIVE MEASURES FOR INFECTIOUS 

DISEASES. 

Smallpox. — Isolate the patient. Smear the surface of the skin with 
oil, vaseline, or glycerine, slightly carbolized, to prevent the infectious 
matter of the disease from diffusing into the air and so spreading. Re- 
ceive the discharges from the body in disinfected vessels. Burn the cloths 
used on nose and mouth. Disinfect the bedding, clothing, and furniture. 
Vaccination is the great preventive. 

Chicken Pox. — No preventive means are needed, as the disease is 
a mild one, always resulting in recovery. 

Measles. — Isolate the patient. Smear the skin with oil, vaseline, 
or glycerine, as advised in smallpox. Disinfect discharges from the 
body. Burn rags used as handkerchiefs and napkins. Disinfection of 
clothing, bedding, and furniture, generally neglected, under the impres- 
sion that the disease is not serious, ought to be done very thoroughly. 

German Measles (Rubella). — No preventive measures are needed, 
as the disease is a mild one. 

Scarlet Fever. — Isolate the patient. Promote the shedding of the 
skin (desquamation), by which the infection is dispersed, by sponging 
the body twice daily with tepid water to which a small quantity of Condy's 
Fluid is added, and by applying carbolated oil or cream of carbolic acid 
(1 in 40). After the fever is over, wash with flesh brush and carbolic 
soap, and apply the carbolic cream or oil (1 in 20). Dress the hair with 
carbolic oil. Syringe the throat and nose with a very weak solution of 



SPECIAL PREVENTIVE MEASURES. 155 

Condy's Fluid or other antiseptic wash. Disinfect the clothing, bedding, 
and furniture. Boil all milk used by the family during an epidemic of 
this disease. 

Typhus. — The most preventable of all diseases; but the means must 
be seriously applied and persistently carried out. Danger of contagion 
is great only near the body of the patient, as the contagium soon dies in 
the air. Isolate. Ventilate thoroughly, even to the extent of outdoor tent 
treatment of the patient. Free use of disinfectants about the room. 
Exclusion of visitors and thorough disinfection of clothing, bedding, and 
furniture. Ventilation is a powerful prophylactic. 

Influenza, or Epidemic Catarrh. — The general mildness of the dis- 
ease does not call for further isolation than the avoidance of mingling in 
gatherings of people. The sputum, of course, should be disinfected and 
destroyed. 

Whooping Cough. — Isolation. Disinfection of the discharges from 
the throat and lungs. Freshening the air by sprays of disinfectant. Dis- 
infection of clothing, bedding, and furniture. 

Mumps. — Isolation and hygienic means. Not sufficiently serious to 
call for stringent means. 

Diphtheria. — Isolation, which must be kept up as long as the pres- 
ence of infectious matter is found in the throat. Sometimes this remains 
for a very long time after the membrane has disappeared. Three weeks 
after the disease has gone 16 the minimum period of isolation. Expecto- 
ration, throat and mouth and nose discharges, are to be received in a 
disinfected vessel and treated with a further application of the disin- 
fectant before destroying. Rags are to be burned, and clothing, bedding, 
and furniture must be thoroughly disinfected. No disease calls for more 
stringent disinfection. The general rules must be thoroughly enforced 
and observed. 

For prevention, all dampness and accumulations of dirt must be 
removed. Careful inquiry must be made of other children in the family 
as to the condition of the throat. Schools ought to be closed during an 
outbreak of diphtheria ; at all events, teachers should make frequent and 
regular inquiry among the children for the appearance of sore throat. 

Typhoid Fever. — Disinfection of the stools in a 1 in 20 solution of 
carbolic acid or in a 1 in 1,000 solution of perchloride of mercury; add 
a further quantity of the disinfecting fluid to the vessel before carrying 
it out. Keep the vessel covered. If the drainage of the premises is not 
efficient, so that the matter will be thoroughly removed, it is safer to 



156 CAUSATION AND PREVENTION OF DISEASE. 

burn it. All of this care must be paid to the discharge because it is the 
principal medium through which the disease is conveyed. Disinfection 
of the clothing, bedding, furniture, etc. Strict isolation is not imperative. 

Yellow Fever. — The general measures for the prevention of an attack 
necessitate the recollection that yellow fever is born in filth. Good sew- 
erage, in order that all excreta may be carried off safely, free ventila- 
tion, no overcrowding, cleanliness, and pure water, are essential. After 
the disease has broken out, isolation; disinfection of vomit and stools, 
with a i in 1,000 perchloride of mercury solution, or a I in 20 carbolic 
acid solution; ventilate the room well, screen the windows to keep out 
flies and mosquitoes, and thoroughly disinfect clothing, bedding, and 
furniture. 

Cholera. — This is another disease that cannot thrive in clean and 
sanitary surroundings. Isolation, rigid attention to the disinfection of 
all discharges, which must be received in a vessel containing from 6 to 
8 ounces of a disinfecting solution ; add the same quantity before remov- 
ing from the room. All discharges should be buried. 

Dysentery. — Avoid exposure and malnutrition, drink only good 
water, and breathe only pure air. Disinfect all discharges, treating them 
with a 1 in 20 carbolic solution or a 1 in 1,000 perchloride of mercury 
solution. 

Malarial Fevers. — Among the predisposing causes of these diseases 
are fatigue, a depressed condition of the body, lack of nourishment, a 
chill, the fact that one has previously had an attack of the fever, and 
recent arrival in a malarial district. 

The exciting cause is a micro-organism known to scientists by the 
name of Plasmodium malariac. It is found in the blood of sufferers 
from this disease. The disease is communicated by the poison entering 
the body through the bite of certain mosquitoes, by drinking water, and 
possibly by inhalation. While it is not contagious, it is more than likely 
that it is transferred from one to another by the mosquito. So far as 
is known, that is the only way in which the poison leaves the 
body. 

After the plasmodium has entered the body, efforts must be directed 
"toward preventing its multiplication. This is done by 5 to 10 grain 
doses of quinine. All malarial patients should be protected by mosquito 
netting to prevent the mosquitoes from transferring the poison to healthy 
persons by inoculation. To prevent the larvae of the plasmodium from 
breeding or hatching, it has been suggested that the marshes and pools 



SPECIAL PREVENTIVE MEASURES. 157 

be drained, or the pools filled up with earth. The fact that a pool on 
the Gold Coast of Africa near the petroleum wells contained no mosqui- 
toes, and consequently no malaria, led to experiments by which it was 
found that the use of one ounce of kerosene to every ten feet of surface 
of the breeding pools of mosquitoes in malarial districts will prevent the 
disease. The adequate protection from mosquitoes by window and door 
screens is a sure preventive. 

Erysipelas. — Predisposing causes are the existence of a wound, dis- 
ease of the bowels, poor food, intemperate habits, and having suffered 
from the disease before. The exciting cause is a micro-organism known 
as Micrococcus pyogenes. It enters the body through a broken surface 
or through an intact mucous membrane. The poison is carried through 
the air exclusively. The preventive measures are good hygiene, food, 
ventilation, and cleanliness, and antiseptic treatment of wounds. 

Septicaemia or Blood Poisoning. — This is a similar disease to 
erysipelas, and requires the same precautions and preventive measures. 
It is caused by bacteria known as Micrococcus pyogenes aureus and Micro- 
coccus pyogenes albus and Micrococcus pyogenes citreus. In addition to 
these are the Streptococcus pyogenes of erysipelas. The disease is very 
generally propagated by soiled instruments, sponges, fingers, linen, cloth- 
ing, etc. In addition to the precautions suggested as preventive of 
erysipelas, there are some special antiseptic measures to be adopted in 
childbirth, when this disease so frequently occurs. The antiseptics recom- 
mended comprise washings of perchloride of mercury 1 in. 1,000, car- 
bolized oil 1 in 8, and Condy's Fluid. These are for use by nurse, medi- 
cal attendant, and for washing the patient. Sponges, instruments, bed- 
pans, and everything of that nature which may come in contact with the 
patient are to be so treated. Soiled linen and bedding must be at once 
removed from the room. 

Tetanus or Lockjaw. — This is caused by the Bacillus tetani enter- 
ing the body through a broken skin. It is widely distributed in the soil, 
street dust, and floor sweepings. The preventive measures are clean 
linens, and the precaution that no dirt or dust reach a wound. The dirt 
on rusty nails and under the finger nails are direct sources of these germs. 

Tubercle. — See article on Phthisis or Consumption, page 165. 

Hydrophobia or Rabies. — The poison enters the body directly by 
inoculation by a bite. The incubation period is never less than a month 
and sometimes as long as a year. The efficacy of the Pasteur protective 
inoculation cannot be doubted. In the past history of this disease the 



158 CAUSATION AND PREVENTION OF DISEASE. 

mortality was ioo per cent. No cures were known. The actual number 
of persons who develop rabies after a bite by a rabid animal is not known, 
but the percentage of deaths among those bitten is over 20 per cent. 
Out of over 1,500 cases treated in one year in the Pasteur Institute there 
were only three deaths. 

DISINFECTION. 

There must be no halfway measures in disinfection, for disinfection 
means, in the newer application of the word, the actual destruction of 
every particle of poison given off by a patient during illness from an 
infectious disease. This work must be regularly and persistently done. 
It is not sufficient to do it in five cases and omit doing it in the sixth. 
It is not enough to remove the discharges from a typhoid patient and 
to throw them out so that they will linger in the soil and find their way 
into water, where they will multiply and be ready to attack and to spread 
the disease. That is only temporizing with disease. If proper precau- 
tions were always taken by those in charge of patients, there would be 
no such thing as epidemics. There will be a few isolated cases just so 
long as people do not observe hygienic laws of living and use ordinary 
protection against disease. One single neglected discharge from the 
body of a typhoid case may be the means of creating an epidemic. 

Disinfectants are physical and chemical. The chief physical disin- 
fectants are : fresh air, sunlight, heat, moist heat, dry heat, boiling, and 
sterilization. 

Fresh Air. — The antiseptic action of fresh air is due partly to the 
union of its oxygen with decaying matter upon which the bacteria thrive 
and in which they multiply. This union of oxygen with other matter 
is known as the process of oxidation. It has the effect of breaking up 
the noxious matter into other harmless substances and of forming with 
them compounds of oxygen that are not favorable to the increase of the 
bacteria. So that, while it does not absolutely kill the germs, it sus- 
pends animation and restrains growth. The effects of sunlight are very 
much the same, so that these two great purifiers of the air are not to be 
considered as germicides nor as substitutes for disinfectants. They are 
not sufficient in themselves to prevent the spread of disease, but are sup- 
plemental to the action of true disinfectants and germicides. 

Heat. — The vegetative forms of most bacteria are killed by a tem- 
perature of 140 Fahrenheit. But destruction of the vegetative form 
does not effect perfect disinfection. For many of the bacteria increase 



DISINFECTION. 159 

by means of parts known as spores, which act as seeds or eggs. If these 
spores are not destroyed along with the parent forms, they will grow and 
increase. A heat of 180 Fahrenheit is needed to kill them, which it 
will be remembered is within 32 ° of the boiling point. As moist heat 
in the form of hot water or of steam is a more destructive means of killing 
bacteria and their spores than is dry heat of a higher temperature, it will 
be seen that boiling Avater is a sure agency to use in killing these forms 
of contagia. But it is found that simply to pour boiling water upon 
them is not sufficient; it is necessary to expose them to its action for a 
length of time varying with the species. Consequently it is necessary 
to coA*er the vessel in which they are being treated for an hour or two 
before throwing them out. If treated for too short a time they will 
revive again under favorable conditions. Ineffective means of disin- 
fecting are worse than none. 

Xot only is a sufficient length of exposure to the disinfecting agent 
necessary, but care must be taken that every part of the matter which is 
under treatment must be exposed to the action of the disinfectant. In 
no other way can one be sure that all of the contagia are destroyed. The 
survival of even one of the bacteria is full of tremendous possibilities in 
the way of a future epidemic. Boiling is therefore one of the most 
effective means of sterilizing, as this method and its effects are called. 
All clothing, bedding, and similar articles that can be boiled for an hour 
will be thoroughly sterilized or disinfected. While it is found that in 
some cases a lower temperature than the boiling point and a shorter 
period of treatment will accomplish the purpose sought, it is better to 
err on the right side than to find out too late that the process has not been 
effective. 

Sterilization and Pasteurization of Milk. — There are four diseases, 
typhoid, scarlatina, diphtheria, and tuberculosis, in the spread of which 
it is tolerably certain that milk plays an important part. While the 
extent and the manner in which diseases are spread by milk are more or 
less open questions, frequently debated, the known facts are such as to 
warrant the employment of preventive measures by all who use milk. 
It has been shown in the preceding paragraph that boiling is a most 
effective method of killing disease germs. We accordingly apply that 
treatment to water which is suspected of containing impurities. It would 
be the safest course to boil milk. But when milk is boiled it undergoes 
certain changes not only in taste and smell, but in the digestibility of the 
casein, the condition of the fat and the coagulation of the albumen which 



160 CAUSATION AND PREVENTION OF DISEASE. 

injure it as a food. Therefore the process of sterilization stops just short 
of the boiling point. It is found that an exposure to a temperature of 
from 150 to 160 degrees Fahrenheit for half an hour will kill all of 
the disease germs found in it except that which is supposed to be respon- 
sible for infantile diarrhcea. 

There are many sterilizers expressly made for this purpose and they 
are all fairly effective. The ordinary method of caring for milk in this 
way is both effective and easily applied in any household. The milk is 
best placed in a glass bottle, the mouth of which is loosely plugged with 
absorbent cotton, which permits the entrance of air but filters it in its 
passage. The bottle is placed in a pan. of water on the stove and care- 
fully watched so that it does not boil or become too hot. As the matter 
is one of experience, it is safer at first to watch the heat of the water in 
the outer vessel for a time with a thermometer, so that one will be able 
to successfully gauge the temperature by the judgment alone. The milk 
is stirred or shaken from time to time to insure all of the contents of 
the bottle being equally heated, and to prevent the cream from coming 
to the top on cooling. It is important that the milk be quickly cooled 
at the close of the process. The advantage of pasteurized milk over 
untreated milk is that 99 per cent of all the disease germs which it con- 
tains are destroyed, the exception being the germ of cholera infantum; 
and its advantages over boiled milk are, that it is more digestible and 
more palatable while its condition as a food is unchanged. 

The difference between sterilized and pasteurized milk is that ster- 
ilized milk may be boiled milk but pasteurized milk never is. 

CHEMICAL DISINFECTANTS. 

Out of the great mass of chemical disinfectants which have come 
forward during recent years, it is necessary to mention only a few. These 
are the disinfectants which have under all circumstances met the. require- 
ments of quick action, efficiency, and ease of application. 

Corrosive Sublimate. — This is the common name given to the per- 
chloride of mercury. In a 1 in 1,000 solution, it kills the germs of 
typhoid, diphtheria, and erysipelas in eight seconds ; and the spores of 
the bacilli of these diseases in a few minutes. It has two important 
disadvantages for general use : it is expensive and it is poisonous. In 
a colorless solution of the latter, the danger is increased, consequently 
it is often colored, so that a solution of it will not be mistaken for water. 



CHEMICAL DISINFECTANTS. 161 

To make a solution of corrosive sublimate of the strength of i in 1,000, 
it is necessary to take — 

Corrosive Sublimate, y 2 ounce. 

Hydrochloric Acid, i ounce. 

Water, 3 gallons. 

If this proportion is observed, the proper strength will be secured. 
For convenience the disinfectant is also sold in tablet form, which enables 
one to make a solution of the requisite strength, in any quantity, with 
ease and certainty. 

While corrosive sublimate is a powerful disinfectant and germicide, 
it is to be noted that it does not destroy the tubercle bacilli in the sputum 
of consumptives. This is explained by the fact that it coagulates the 
exterior of the sputum so that it cannot affect the inner parts of it, and so 
cannot reach the tubercle. This, so far as is known, is its only limitation. 

Carbolic Acid. — In the proportion of 3 per cent, carbolic acid kills 
the germs of typhoid, diphtheria, and erysipelas in eight seconds, but 
the spores withstand even a 5 per cent solution for several days. It there- 
fore is inferior to the corrosive sublimate as a spore killer, and conse- 
quently as a germicide. But a 5 per cent solution of carbolic acid will 
kill the tubercle bacilli in thirty seconds and the spores of it in one hour. 
Its prompt and effective action on germs, and its ease of application, make 
it a good antiseptic. 

Formalin. — This is the vapor formaldehyde dissolved to the extent 
of 35 to 40 per cent in water. Neither the vapor, formaldehyde, nor the 
solution of it, formalin, is poisonous, although both have a very pungent 
and irritating odor. In both of these forms it is a very powerful disin- 
fectant. It kills, in the form of a 3 per cent solution of formalin, all 
forms of disease germs in from one to fifteen minutes. Even in the weak 
preparation of 1 in 10,000 parts, formalin prevents the growth of cholera, 
typhoid, and diphtheria germs. 

The ordinary strength of formalin is obtained by dissolving or mixing 
four ounces of formalin in one gallon of water, to which is added five 
ounces of glycerine, which has the effect of preventing change in the 
solution and also causes it to dry more slowly. 

Formaldehyde. — The gaseous form of formalin is regarded as one of 
the most effective gaseous disinfectants in use. It is little likely to dam- 
age objects upon which other and more powerful disinfectants have an 
injurious effect. 



162 CAUSATION AND PREVENTION OF DISEASE. 

Chlorine. — This gas is one of the best disinfectants in use. It does 
its work much better in the presence of dampness than in dry atmos- 
pheres. The change which it brings about in objectionable and unhealthy 
matter is a real chemical change; it has such an ease of union with the 
gas hydrogen, which is present in all vegetable and animal matter, that 
it unites very quickly with it. In this union it breaks up the matter 
which originally contained the hydrogen and forms entirely new and 
harmless compounds with it. 

It is liberated when water is poured upon chloride of lime. The 
amount liberated by the action of water is comparatively small and slow. 
But if hydrochloric acid be poured on the chloride of lime, the supply is 
greatly increased. The gas also bleaches and destroys foul odors. Three 
pounds of chloride of lime and three pounds of commercial hydrochloric 
acid for every 1,000 cubic feet of space will kill all of the disease germs in 
eight hours. The walls and ceiling should be moistened to get the best 
results, and the vessels in which the generation of the chlorine gas is being 
conducted should be placed high, as chlorine gas is heavier than the air 
and therefore sinks toward the floor. 

Sulphurous Acid. — This is a gas that is given off when sulphur is 
burned in the air. It has had for a long time a great household reputa- 
tion as a strong and efficient disinfectant; and it seems hardly possible 
that germs of disease can withstand the powerful pungency of its fumes. 
But recent experiments have served to show that its value for this pur- 
pose is overestimated. It appears that the slightest covering is a suffi- 
cient protection for germs against its effects. Its efficacy is greatest in 
the presence of moisture, and it is employed in the proportion of three 
pounds of roll sulphur to every 1,000 cubic feet of space acted upon. 

Quicklime. — This is a powerful germicide, and a i-io per cent solu- 
tion of it will kill typhoid and cholera germs in five hours. It is also used 
to disinfect damp places and dry or earth closets. 

Permanganate of Potash. — While this is a good disinfectant and 
a valuable antiseptic and deodorant, it is useless in practice, as its force 
is expended in attacking the organic matter in which germs are found. 
So much of its energy is used in this direction that enormous quantities 
would be required to accomplish the desired end. 

It must be conceded that corrosive sublimate and carbolic acid are 
by far the best agents known to science for disinfection and germicide 
uses. 



PRACTICAL DISINFECTION. 163 

PRACTICAL DISINFECTION. 

One of the first subjects in the practical disinfection in the sick room 
during infectious disease is the disinfection of the discharges from the 
body. It is in these that a great danger of the spread of the disease 
lurks, and prompt and persistent efforts must be made in this direction. 
In considering the special diseases in a previous section, reference was 
made to the special means of accomplishing this object in particular 
cases. These directions may now be summed up. 

The faecal and urinary discharges must be received into a bedpan, 
or other vessel, in which are placed from six to eight ounces, about 
half a pint, of either corrosive sublimate solution, 1 in 1,000, or a carbolic 
acid solution, 1 in 20. The corrosive sublimate solution of the required 
strength may be made by taking — 

Corrosive Sublimate, y 2 ounce. 

Hydrochloric Acid, 1 ounce. 

Water, .3 gallons. 

The carbolic acid solution of this strength, 1 in 20, is made by taking — 

Carbolic Acid, 8 ounces. 

Water, 2j^ gallons. 

Immediately after the discharge is received into the vessel, a further 
quantity of the disinfecting fluid is to be poured in. If the discharges 
are fluid and copious, this after addition must be very liberal. 

The diseases to which this procedure especially applies are : typhoid 
fever, cholera, dysentery, consumption of the bowels, and yellow "fever. 
In any of these diseases the vomit is to be treated in the same way. 

Discharges from the Mouth and Nose. — These discharges are to 
be received either into vessels, as in the previous mentioned cases, and 
treated in the same way, or are to be collected in rags used as handker- 
chiefs or napkins, and afterward burned. The diseases in which this is 
to be done with special care are : diphtheria, whooping cough, scarlet 
fever, smallpox, measles, and consumption. In the latter case, the 
sputa will best be treated with a solution of carbolic acid, 1 in 20. In 
scarlet fever and diphtheria it is well also to spray the throat with some 
disinfectant. 

Discharges Through the Skin. — Smallpox, measles, and scarlet 
fever are the chief diseases in which the poison of the disease leaves the 



164 CAUSATION AND PREVENTION OF DISEASE. 

patient's body through the skin. It is in the crusts of the pustules of 
smallpox, in the scales of skin (the epithelia) of measles, and the peeling 
skin of scarlet fever that the poison abounds; and by it the infection is 
spread as it passes into the air. It is well on this account to apply oil, 
vaseline, glycerine, either plain or carbolized, to the skin, with a view to 
preventing these particles from floating promiscuously through the air. 
By confining them to some such agent as an oil they are retained until 
removed by the bath. The bath should for this reason be of a mild dis- 
infecting nature, and the water of the bath after bathing should be dis- 
infected with the carbolic or corrosive sublimate solution. 

Typhus fever discharges the contagia of that disease through the 
pores of the skin. This contagium loses much of its infectious power 
when reaching the air. Therefore free ventilation is necessary to carry 
off this infectious exhalation from the body. By passing out of the room 
into the larger space of the air its power is greatly weakened by dilution, 
and the danger of infection by it is destroyed. While confined to the 
small space of the sick room, it is concentrated and therefore virulent and 
dangerous. The greatest danger from infection in typhus and relapsing 
fevers lies close to the body of the patient. 

Disinfection of Clothing and Bedding. — The systematic and really 
efficacious method of disinfecting very large and bulky articles is by 
means of moist or dry heat, and as the apparatus for this purpose is out 
of reach of houses and homes generally, other means must be employed 
which, if not so good, are the best obtainable. Such clothing and articles 
of bedding as blankets, sheets, pillowcases, and all washable articles 
as can be soaked or boiled, can be thoroughly disinfected. There are 
several good solutions which will do this work perfectly. A carbolic 
acid 5 per cent solution is the i in 20 solution previously mentioned on 
page 163. A chloride of zinc, 1 in 240, or chloride of lime solution of 
two ounces to the gallon, or the corrosive sublimate, 1 in 1,000 solution, 
will answer admirably. The articles must be soaked for from twelve 
to twenty-four hours, after which they are to be boiled and washed. 

Disinfection of Rooms and Furniture. — A room cannot be disin- 
fected and occupied at the same time, for the process renders the air 
entirely unfit for breathing. All articles that can be otherwise treated 
as before mentioned are of course removed. Closets are opened so as 
to get full effects of the disinfectant. The windows, doors, and all other 
openings are to be closed. The room is then to be fumigated for three 
hours with either chloride of lime, formaldehyde or sulphurous acid. 



PREVENTION AND CURE OF CONSUMPTION. 165 

The proper quantities and proportions of these are given on page 162. 
After the fumigation has lasted for three hours, the doors and windows 
are opened to insure thorough ventilation for from twenty- four to thirty- 
six hours. If the house is otherwise occupied, it will be impossible to 
have the doors communicating with the living apartments open. But all 
other possible means of ventilation must be made use of. Those who are 
employing the disinfecting means must be careful not to expose them- 
selves to the fumes, for there is great danger of being overcome by them. 
The paint and woodwork must now be scrubbed thoroughly with a 1 in 
1,000 corrosive sublimate solution, or with soft soap, or with both. If 
the walls are papered, all of the paper, including every layer of paper, 
must be taken off, and the walls washed with hot lime before being 
repapered. The ceiling is also washed with the same. The wooden furni- 
ture is to be washed with a 1 in 20 carbolic acid solution or the formalin 
spray of 1 in 40, or the 1 in 1,000 corrosive sublimate solution. It is of 
infinitely greater importance that the walls, ceiling, and woodwork of a 
room, and the articles of furniture in it, receive a thorough treatment 
than that the air of the room alone be so treated, for the air in the room 
may be easily changed and a fresh supply procured. The other parts of 
the room afford lurking and hiding places for the germs, and the room is 
unsafe for occupancy until these have been thoroughly disinfected. 



MODERN METHODS OF PREVENTING AND 
CURING CONSUMPTION. 

The message which Robert Koch, a physician in an obscure German 
village, gave to the world in 1882, is by far the most valuable contribu- 
tion to the public welfare that has been made in modern times. In this 
message he announced that consumption is spread like other contagious 
diseases; that this greatest of all scourges can be prevented; and, most 
important of all, that those who are afflicted by this "great white plague" 
may be cured if they take the necessary precautions in time. The direct 
result of Koch's discoveries is that the work of stamping out this fright- 
ful menace to public and personal health and life is placed, not upon the 
physicians of the country, but upon every individual in the community. 
As it is upon the intelligent and united action of every man, woman, and 
child in this country that the prevention and cure of consumption depend 



1 66 CONSUMPTION. 

there is no hope that this result can be achieved, even in a slight degree, 
unless the means and the principles of their application are thoroughly 
understood. 

Ravages of Consumption. — It is the most widespread of all diseases. 
Every nation in the world suffers from it. Every year, in the United 
States, a part of the population equal to the entire population of a city 
the size of Indianapolis, Kansas City, St. Paul, or Rochester, N. Y., dies 
from it. That means 160,000 persons a year, or about 438 every day 
in the year. Every hour, in this country, eighteen persons die from the 
effects of a disease which can be prevented. The public is appalled by the 
death of four or five hundred persons in a burning theater, or on a burn- 
ing steamer, or in a great earthquake. But every day an equal or greater 
loss of life occurs, in isolated cases, with an awful train of sorrow and 
suffering, to say nothing of commercial and economic loss. 

We have learned to look upon diphtheria, scarlet fever, and cholera 
as diseases which cause a great many deaths. Yet all of the deaths from 
cholera, diseases of the bowels, diphtheria, scarlet fever, and measles, 
combined, do not equal one-half the deaths from consumption. Generally 
speaking, one out of every ten inhabitants dies of consumption ; in cities, 
one out of every seven. Out of all of the deaths of persons between the 
ages of fifteen and twenty-four years, consumption kills one out of four; 
between twenty-five and thirty-four, one out of three ; between thirty-five 
and forty-four, one out of four. Pneumonia is the only disease that 
approaches consumption in point of fatality. 

What Consumption is Now Known to Be. — Consumption is a con- 
tagious or infectious disease. Koch demonstrated conclusively that it is 
caused by a microbe which enters the body and multiplies there enor- 
mously, even to the extent of 16.000, coo in 24 hours. This microbe is 
called the Bacillus tuberculosis. Bacillus is the Latin word for a little 
rod or stick; and the creature is so named because that is what it looks 
like when seen under a very high power microscope, which is the only 
way it can be seen, and then only when stained red. In this condition 
the bacilli most resemble a lot of very small cuttings of fine red silk 
thread. It takes three thousand of them, end to end, to measure an inch 
in length, and there may be 200,000,000 of them in a spoonful of milk 
without one realizing that there is anything but milk in the spoon. These 
bacilli were found by Koch in the bodies of every one suffering from 
consumption; but that fact alone was not sufficient to prove that their 
presence was the cause of the disease. A few of the bacilli were taken 



HOW CONSUMPTION IS SPREAD. 167 

and put into a small glass tube containing a jelly or a bouillon, and the 
open end of the tube was plugged with absorbent cotton to keep other 
bacteria out. The tube was then left undisturbed in a warm place for 
some time. This is what is called a culture, for the bacilli grow and 
increase in numbers under these favorable conditions. Some of the 
matter was then injected into rabbits and guinea pigs. Guinea pigs are 
chosen for such experiments because the behavior of the disease germs 
in their bodies is most like that in the human body. After a lapse of 
time, some of the animals were examined and were found to be suffering 
from consumption. Others were allowed to die from the disease, and, 
on examination, like conditions were met as are found in human sufferers. 
Some of this matter was in turn used upon other healthy animals, and 
the poisonous nature of the bacilli proved beyond a doubt. 

The disease is called tuberculosis, for in the progress of it, and after 
the germs have begun to multiply in the lungs, there are formed a number 
of tubercles. Tubercles are little tubers, and tubers are such root-like parts 
of plants as the potato. The tubercles in the lung are small roundish 
bodies about one-sixteenth of an inch in diameter. They are formed out of 
the healthy tissues in which the bacilli lodge and are of a grayish, semi- 
transparent appearance. They first become of a substance like cheese, 
and this later turns to pus. Little by little the germs multiply, change 
the tissues in which they live into tubercles, and break down all of the 
structure of the organ and scatter their poison through the body. The 
body tries to throw that poison off by fever, known as hectic fever in this 
case; the parts are slowly consumed, and the patient eventually dies of 
consumption. These tubercles are found in many other parts of the 
body besides the lungs. There are tubercular joints, hip joint disease, 
consumption of the bowels, and other parts are similarly affected by the 
bacillus, and in all of these affections tubercles are formed. 

How Consumption is Spread. — The Bacillus tuberculosis, the cause 
of all infection, enters the body by several pathways. The most common 
of these is by the nose, mouth, and throat, in the process of breathing. 
Some also enter with the food and are taken into the stomach and the 
digestive organs. They leave the body of a consumptive person chiefly 
in the sputum, the matter which is coughed up during the progress of 
the disease. It has been estimated that a person suffering from con- 
sumption discharges into the air in the sputum from 200,000,000 to 
23,000,000,000 of bacilli every twenty-four hours. If this sputum with 
its immense number of bacilli is spit out upon the sidewalk or on car 



1 68 CONSUMPTION. 

floors, and in similar places, there are several ways in which it may be 
scattered abroad to become infectious. The sputum may dry and be 
ground as fine under foot as dust to be whirled by the wind into 
the air. It is then one of the solid impurities of the air, and 
in that form is breathed in by those who come within its range. Or it 
may be tramped on by passers-by and attach itself to their shoes, or 
gathered up by sweeping skirts and be carried into the homes. Here it 
finds a lodgment and becomes dried upon the carpets. On sweeping the 
floors it is raised upward in the dust of that process to be breathed in 
by the occupants of the home. In such ways it invades the homes of all 
classes, and bacilli are present in rooms where there has never been a 
case of the disease and where it is least expected. That this is no alarm- 
ing theory or a mere possibility was abundantly proved by Cornet, the 
Berlin scientist. He scattered a small quantity of sputum on the carpet 
of a room and allowed it to dry for only two days. He placed about 
fifty guinea pigs on the floor of the room. Then the carpet was vigor- 
ously swept. The guinea pigs were allowed to breathe the dust in the 
ordinary way. All but two of them died from consumption thus con- 
tracted. In the overcrowded and ill-ventilated clothing factories and 
workrooms in large cities there are present many conditions favorable to 
consumption; and the sputum carelessly discharged upon the floor is 
dried quickly by the steam heat of the buildings, and bacilli in great 
numbers are not only breathed in by the workmen but infest the clothing 
that is being made and which is sold all over the country. Even in the 
acts of sneezing and coughing by a consumptive, when no perceptible 
amount of sputum is discharged, a perfect shower of bacilli is violently 
forced into the air in the fine particles of sputum which always accom- 
pany these acts. Patients often smother a sneeze or a cough in the bed- 
clothes, and so the bacilli are received into them. The mustache and 
the beard of a consumptive become perfect hives of infection, especially 
as so many men allow the beard to grow long, either for comfort or as a 
protection to the throat in ccld weather. The walls of rooms in which a 
consumptive has lived and died have been known to retain the bacilli in an 
active state for over two years after the termination of the case. These 
are some of the ways in which bacilli are spread through the air and 
carried from place to place. No man lives long enough to be able to 
count, during his entire lifetime, the number of bacilli which a con- 
sumptive carelessly and needlessly discharges into the air in a few 
hours. 



HOW CONSUMPTION IS SPREAD. 



169 



These myriads of bacilli are breathed into the air and are taken into 
the lungs by all who come in their way. Every one breathes them, and 
they lodge on the teeth, the tonsils, in the throat, and in the lungs of all, 
healthy and unhealthy alike. Dr. Cornet examined a very great number 
of healthy persons who were accustomed to frequent public places, and 
he found bacilli in the mouths of over 75 per cent of them. They lie 
there in wait with infinite patience, for upon the healthy, right living 
man their attacks are useless. But let him neglect his hygienic mode 
of life, let him be guilty of continued indiscretions, let him become weak- 
ened and enfeebled by disease, hunger, privation, and exposure, then he 
succumbs. And the patience and relentless attack of the invisible little 
microbe kill one out of every four persons. 

And yet even the healthiest in appearance must not be too sure that 
they have never been caught by this ever present and watchful enemy. 
The post-mortem examinations have shown repeatedly that persons who 
had never been suspected of having consumption have had an attack, and 
the scars on the lungs ■ 
prove that they had 
vitality enough or 
adopted right modes 
of living in time to 
overcome the attack, 
in other words, to be- 
come cured. These 
are not isolated cases. 
These revelations are 
of almost daily occur- 
rence, and are the 
most convincing proof 
of the curability of the 
disease. No man can 
say positively either 
that he has not had 
consumption or that he 
is not now attacked by it. Were this possible, the stamping out of this 
insidious disease would be only a question of a very few years. 

Persons Most Likely to Be Attacked. — There is great difference 
of opinion among scientists regarding the transmission of consumption 
from parents to children. Medical journals are filled with articles affirm- 




Fig. 45- 



Cot and Bedding Arrangement for 
Porch Sleeping. 



170 CONSUMPTION. 

ing and denying the possibility of the communication of the disease in 
this way. But upon one point all are agreed, that there is no doubt that 
children of consumptive parents, one or both, inherit such a weak con- 
stitution and so enfeebled a state of health, that they start life with a 
marked predisposition to the disease. These, then, form a large propor- 
tion of those who are liable to be attacked by consumption. But that 
does not by any means imply that they will take it. For facts prove that 
the very large majority of them do not take it. A statistician of a large 
insurance company gave -facts before the Tuberculosis Congress in Eng- 
land that should set that point at rest forever. Forty thousand applica- 
tions for insurance were refused because there was a family history of 
consumption. These cases were followed up, and it was found that 
less than nine per cent of that large number took consumption. Less 
than one out of ten took it. And this is the class which in popular 
opinion is doomed from birth because it is in the blood. If those figures 
prove anything they certainly prove that the inherited predisposition to 
the disease is no greater a predisposition than are those from other 
causes. For one out of ten the world over is the average mortality 
among all classes of people. 

Right here let us drive home to the members of that class all the 
hope that this fact gives them. You are under no ban because your 
father died of consumption. You are not doomed to the disease. You 
are not going to die of it unless you are willing to. Your chances of 
escaping it are as great as anyone's, if you do your part. To this 
class are to be added all those who have inherited a weak state of 
health and a poor constitution from their ancestors. There is in fact 
no good reason why the two classes should be separated. The bacilli 
will find a favorable field for operations in both, in one just as good as 
the other. It is impossible to tell anything about a person's vitality or 
constitution, or power of withstanding disease, with absolute certainty 
from his appearance. Every one can cite case after case from his own 
observation, no matter how limited, of those who were apparently sound, 
splendid specimens who succumbed quickly to an attack. They can 
supplement this with other cases of those who were apparently not at 
all endowed with powers of resistance who have seemingly more than 
once come back from the gates of death. It is a fact that men of flesh 
and men of muscle have, in the great majority of instances, proved but 
t oo easy a prey to the bacillus of consumption, perhaps because too much 
was expected from their apparent vigor. Nearly every doctor has at 



HOW CONSUMPTION MAY BE PREVENTED. 



171 



least a mental note of more than one instance where a whole generation 
of the same family of heavy, powerfully built persons succumbed to 
this disease, although they gave every promise of escaping all danger 
from it. The vital resistance to the disease was poor, although the 
physique appeared excellent. 

There are two types of build which are particularly prone to 
the disease. The one is represented by those who have inherited a 
poor chest development, so poor that the lower portions of the lungs 
seldom if ever are filled with air. These have a light build, small 
bones, delicate features, thin skin, and blue veins about the temples. 
The second type is a remarkable contrast to these. It includes those 
whose bones are large, muscles powerful, of that build known as "lanky." 




Fig. 46. Sleeping Quarters at the Sanitarium for Consumptives 
at Liberty, N. Y. A Winter Scene. 



In these two types, especially the latter, consumption usually runs a rapid 
course. The last class of which we have to speak is the largest of all. 
It is larger than all others combined. It is those persons who do not 
live hygienic lives. The indiscretions, the carelessness, the ignorance, 
and the willfulness of men and women, together with the poverty of 
the lives of many of them, are the great predisposing causes to the deaths 
by consumption. 

How Consumption May Be Prevented. — The first step in the pre- 
vention of consumption is to destroy the bacillus as soon as it leaves the 
body of the patient. As it passes off in the sputum, this means that 
the sputum from one suffering from the disease must be thoroughly and 



172 CONSUMPTION. 

effectively destroyed. There are several good ways of doing this. A 
regular sputum cup may be provided, in which a small quantity of the 
disinfectant and germicide, the perchloride of mercury, is placed. The 
perchloride solution is the regular i in 1,000 solution made by dissolving 
one-half an ounce of mercury perchloride (corrosive sublimate), and 
one ounce of hydrochloric acid in three gallons of water. This kills the 
germs or bacilli, and the destruction is complete. If there are facilities 
for burning the sputum, a paper cup, moist rags, old newspapers made 
into books, may be used to spit in, but they must be promptly and regu- 
larly burned. This care in the disposal of the sputum must be rigidly 
performed. There should be absolutely no spitting in public places, on 
the sidewalks, in cars, on floors anywhere, nor on carpets. As pointed 
out before, this is the most prolific means of infection. The bacilli are 
carried about on clothing, dry up and form dust, which is blown about 
and inhaled, and escape from infection is impossible. Not only should 
spitting in public places by consumptives be stopped, but the practice 
should be prohibited to every one. If a spitter have not consumption, and 
no one can be sure that he himself has not, he is only passing along such 
bacilli as he has inhaled and which have attached themselves to his throat 
and tonsils. The enforcement of the ordinance in some cities is not alone 
on the grounds of cleanliness but to prevent the spread of this disease. 
If a person must spit, let him be both sanitary and decent about it. Let 
him spit off the curb into the roadway; that is bad enough, and is also 
a means of infection, but it is not so bad as the risk of it being carried 
about on the clothing of passers-by into their homes. The danger of 
spitting on carpets as a means of infection has already been demon- 
strated. It is an easy matter to spit in spittoons which have water in 
them, to spit into a sewer grating, and generally to use a little precaution 
in disposing of the dangerous and offensive excreta from the mouth and 
lungs. It is not right that this matter should be swallowed,, as there is 
very great possibility of carrying the infection into the stomach and 
bowels, both of which are extremely subject to tubercular infection. 

A consumptive should also never cough or sneeze without covering 
the mouth and nose with a wet cloth. He should always have at hand 
for use a supply of such material, which may be burned after use. The 
acts of coughing and sneezing being both explosive in nature and intended 
to force matter from the lungs, throat, and nose, violently expel much 
of this infectious matter into the air. 

A consumptive person should never kiss another on the mouth. In 



HOW CONSUMPTION BEGINS. 173 

spite of the comic paragrapher's humor on this point of infection, there 
is positive danger of communicating disease by this means. He should 
sleep alone and occupy a separate room. These points on the disposal 
of the sputum and other preventive measures have to do principally 
with the prevention of the spread of the disease to others. It is the 
dissemination of the bacilli that increases the possibility of infection by 
those who are disposed to the disease. A person who is predisposed to 
consumption should avoid infection as far as possible. He should live 
outdoors all that he can. Many have changed their occupations to secure 
the sunlight and fresh air, with most favorable results. The mortality 
is greatest among those whose occupations cause the breathing of particles 
of metal, stone, etc., and among those who are most confined. The glass- 
workers, stoneworkers, hatters, bookkeepers, cigarmakers, printers, sup- 
ply a very large proportion of deaths. 

Predispositions of all kinds are to be closely watched in the early 
years of life. If a child display a tendency in family history, build, 
constitution, or if he has been enfeebled by weakening disease, let him 
be given all of the outdoor life possible. Let him drop school for. a time. 
Never mind if he does not keep up with his class; give him a chance to 
keep up with life. The rivalry of school classes and the fear of not 
making a school year with his classmates are sometimes very pernicious. 
The choice of a profession or of a career in life must be largely influenced 
by his physique. Dangerous occupations and those which entail confine- 
ment are not for children or young men and women with any predispo- 
sition to disease. An outdoor life is not only advisable but imperative 
in all such cases. Fresh air and sunlight are not only in themselves a 
means of destroying the bacillus and its poison, but are powerful agents 
in increasing the vital resistance to the disease. That is what all of the 
preventive means should aim at doing. Kill the bacillus, and build up 
a weakened constitution so as to withstand its attacks. The curative 
agencies, which will be taken up later for consideration, are to be 
employed to a degree in the prevention where a possibility of contracting 
the disease is feared. 

How Consumption Begins: Early Symptoms. — Consumption 
begins by the admission, under circumstances favorable to its growth, 
of the bacillus into the lungs through the organs of respiration. What 
it will do after it gets in depends entirely upon the virulence of the 
bacillus, the state of health of the person, the condition of the organ or 
part affected, and the power of resistance of the individual attacked. If 



174 



CONSUMPTION. 



there is no predisposition to the disease ; if the person is in good health and 
is living a careful, hygienic life ; if he is not weakened by an enfeebling 
disease, such as pneumonia, typhoid, measles, whooping cough, etc. ; if 
his health and strength are sufficient to resist the invasion; then the 
bacillus can do nothing, but is expelled in time by coughing and spitting. 




Fig. 47. Temporary and Perma- 
nent Porch Arrangements 
for Bad Weather. 



But if any of these conditions are present, in a greater or less degree, 
then the bacillus begins to act. It first sets up an accumulation of cells 
in the immediate neighborhood. These cells vary in size and in the 
nature of their contents. They form a tubercle. In cases of cure, these 
tubercles, which contain the bacillus, are walled up by a tissue so that 
the bacillus cannot get out to attack other tissues, and can work no further 
harm. This is accomplished by a healing process, and when it occurs 
a scar is left on the lungs just as a scar always marks the place of a wound. 
This happens in hundreds of thousands of cases, and usually without the 
individual knowing that he has had the disease. This is important to 
be remembered, for there is no clearer and more convincing proof of the 
possibility of a cure of consumption than the fact that this cure takes 
place in so many cases, and often without any direct effort on the part 
of the individual. Certainly much more success can be hoped for when 
well directed efforts are made to bring about these very conditions. 



PROGRESS OF THE DISEASE. 



175 



But if the disease does not terminate in this way at this stage, the 
next step is the death of the tissues which have been affected by the 
bacillus, which passes on to attack other parts in the vicinity, the bacillus 
meanwhile increasing enormously and rapidly. If these tubercles are 
quite small they are called miliary tubercles, as they are said to be about 
the size of a millet seed; but when a number of these miliary tubercles 
unite to form one large tubercle, the latter is called a nodule, a word 
derived from the Latin and which means "a little knot." Inflammation 
sets up in the part affected, and, as is always the case when inflammation 
occurs, there is a secretion which surrounds the tubercle and confines or 
limits the operation of the bacillus to that particular area, and so pre- 
vents the spread of the disease for a time. This matter secreted by the 
inflammation surrounds the tubercle with the bacilli, and, in a very great 
number of cases, grows in- 
to a tough envelope or 
covering so strong that the 
bacilli are walled up inside 
of it, cannot escape, and 
are either prevented from 
getting out as stated or are 
destroyed. The part of the 
lung inside of the envelope 
dies or becomes useless for 
breathing purposes ; the 
scar is left and the disease 
is stopped. This, then, is 
a cure at a later stage of 
the disease. 

If, however, the wall 
or envelope is absorbed 
while the bacilli are alive 

and active, or if it breaks down and allows the bacilli to escape, 
the attack is at once made upon the lung tissue, and the operations are 
extended. Sometimes a disease like pneumonia, typhoid fever, or influ- 
enza works a change in the envelope or covering of these walled up 
sections of the lungs, and an attack is made by the liberated bacilli upon 
the neighboring tissues. This is the condition popularly known as 
"rapid decline," which often follows these and other diseases. This 
stage of the consumption may have existed unsuspected for some time, 




Fig. 48. 

Sleeping out of doors on an Open Porch 

in Fine Weather. 



176 CONSUMPTION. 

and it took the other inflammatory disease to break down the sealed up 
barriers and to give the disease full sway with a speedy termination. 

The formation of this envelope or barrier to the further progress of 
the disease does not always take place. Where there is little or no 
resistance to the attacks of the bacilli, a general spreading of the poison- 
ous matter takes place through the tissues, and, as there is nothing to 
impede its advance, the course of the disease is very rapid. 

Early Symptoms. — In the cure of consumption so much depends 
upon its speedy detection that it is well to have in mind the early symp- 
toms of the approach of the disease. It is not supposed that these are 
always within the power of the ordinary person to detect. There must 
always be the assistance or direction of the physician. No one is capable 
of diagnosing his own complaint. Even physicians do not attempt this 
in their own cases when ill, but every one should know the warnings of 
the approach of consumption so as to be able to tell when a thorough 
examination by a skilled physician is needed. The neglect to do this 
upon reasonable grounds for suspecting the existence of incipient con- 
sumption is criminal negligence. 

It is a common belief that an attack of consumption is heralded by 
a cough. This is not true of a very great many cases. Sometimes the 
first symptom is a rise of temperature in the evening. This rise may 
be very slight and be preceded by a chilly sensation. A clinical ther- 
mometer will tell whether this rise is real or fancied and the extent of it. 
The average normal temperature is 98.4 , and the temperature should be 
taken during the day and at evening for comparison. 

In other cases the first symptom is persistent hoarseness. That is 
when the effects are first shown in the larynx. When this huskiness of 
voice does not quickly yield to ordinary treatment, an examination for 
consumption must be made. "Only a slight cold" works a lot of damage 
at this stage of the disease. 

Again, the earliest symptom may be the spitting of blood. This does 
not always mean consumption, but in the great majority of cases it does. 
It may mean acute pneumonia or some form of heart trouble, with rup- 
ture of the blood vessels, but both of these conditions will soon be deter- 
mined by examination. 

The symptoms of consumption do not develop in the same order or 
in the same degree in all cases. If they did the task of deciding accu- 
rately would be much simplified. There are two symptoms which come 
some time or other in all cases. They are fever and loss of weight. 



EARLY SYMPTOMS. 



177 



The fever of consumption does not usually run to very high tem- 
perature. It is generally moderate, and runs from ioo° to 102 and 
rarely to 103 °. If it runs higher than this it may be caused by some 
complication such as blood poisoning. It is high in the evening and 
low in the morning. It is easy to relieve it but only temporarily. 

Loss of weight is 
caused by loss of appetite, 



\ 



Y 




Fig. 49. A Sheltered Cot for an Infant 

TO SLEEP IN OUT OF DOORS. 



cough, and consequent 
loss of sleep, and by ex- 
haustion, indigestion, 
anaemia, and the absorp- 
tion of poisons generated 
by the disease. Sometimes 
the loss of flesh proceeds 
at the rate of four or five 
pounds a week. This is a 
sign that the disease is 
making rapid progress. 
Gain in weight, on the 
other hand, indicates that 
the disease is making slow 

headway, or that its progress has been stopped, and that the healing, 
walling-up process has begun. 

Night sweats, as so many suppose, do not aggravate the disease; but 
on the contrary, are the natural means of relieving conditions. They 
are to be regarded as an effort to reduce the effects of the absorption of 
poison into the system. For it is by the perspiration of night sweat that 
the poison of the disease is carried off. 

The cough is a very generally constant symptom of the disease. It 
is usually worse at night and in the morning on rising. As it is a reme- 
dial means of clearing out the accumulations in the lungs, it is not to be 
stopped. At first it is a dry hacking cough, and is not accompanied by 
much discharge, for the simple reason that the disease has not progressed 
far enough to form matter in the lungs to be discharged. It is the 
method by which the lungs are kept clear. Later, when there is much 
discharge, it is sometimes so severe as to cause loss of sleep, exhaustion, 
and even vomiting. 

When sputum is present it, too, is a symptom, for it is capable of 
microscopical examination which will disclose the presence of the bacilli. 



i 7 8 



CONSUMPTION. 



The Board of Health in the city of New York is equipped to make a free 
examination of sputum, and give a report on its condition, and the pres- 
ence or absence of bacilli in it. Still, it must be remembered that the 
absence of bacilli in sputum is no proof that the disease is not present 
at that time. Bacilli may be present in the lungs but in the walled-up 
condition already mentioned. 

Modern Methods of Curing Consumption. — It is well to start with 
the clearly stated announcement that there is no medicine known which 

will cure consumption. 
Those who rest their hopes 
upon this or that medicine 
Which they have read about, 
or been told about, are lean- 
ing upon the worst sort of 
a broken reed. They are 
not only not going to be 
cured by any of them, but 
they are wasting valuable 
time and are allowing the 
bacilli to get such a start 
upon them that they will 
probably never overtake the 
disease or head it off. This 
plain statement is made 
without reserve. There are 
some medicines which will 
help him in the complica- 
tions which so often attend this disease. There are some medicines which, 
in the hands of the proper person, will relieve him of pain and incon- 
venience. But there are positively no medicines which will cure con- 
sumption. Those which will help him will be considered in the proper 
places as they come up. The things which do cure consumption, and 
are curing lots of cases every year the world over, do not come from 
drug stores or out of bottles. They are abundant, and yet are, in some 
cases, hard to get. The first is fresh air — not a little bit of fresh air 
through a half inch of raised window once in a while, but a regular supply 
of it got by living out of doors, sleeping out of doors, if possible ; at any 
rate, by being out of doors as much as possible. Fresh air will not only 
kill the bacilli but will give the patient a vital power to resist the disease 




Fig. so. Arrangement of Awnings on a 
Lower Porch for Shelter in Bad Weather. 
The Head of the Bed is seen through 
the Opened Door. 






CLIMATE. 



179 



and to seal the germ up in a sac whence it cannot escape and so destroy it. 
There are places where a consumptive can live out of doors, and there 
are other places where he cannot. The thing, then, to do is to find out 
where he can live out of doors and to get there as soon as possible. The 
one great thing is to get where it is dry. Humidity is above all things 
to be avoided, for it is the life of bacilli. The old much-vaunted effi- 
cacy of the sea voyage on a sailing ship is all over and forgotten. There 
are no more good old sailing vessels, and even if there were, the air at 
sea is not dry, but damp. There are seasickness, personal discomfort, 
and being shut up in stuffy places during bad weather. All of which 
will not do. In the out-of-door life the temperature makes no difference. 
Dress accordingly. People get well in the cold, dry air of Canada and 
the northern states just as well as in Florida and on the Pacific coast. The 
old theories of not going out before 9 a. m. or after 4 p. m. are exploded. 
Not only go out but sleep out if 
you can. Of course you can in 
summer, and, with proper ar- 
rangement, you can in winter 
too. Hundreds are doing it to- 
day and are getting well too. 
Draughts? They are better for- 
gotten. The fear of them and 
the precaution to avoid 
draughts that never existed, 
or never came near a patient, 
have killed more consumptives 
than direct draughts ever did. 
If you can, sleep in a tent out in 
the open where there is plenty 
of good, fresh air. The tent is 

sheltered from direct winds ; and it is made of thick canvas that the air 
does not blow through. The air is admitted in ventilators in the sides 
and passes out of the top. There is no draught. Night air? That is 
another bugbear. As Florence Nightingale said, when told that one 
must not breathe the night air: "Why, doctor, what kind of air must 
one breathe at night if one cannot breathe night air?" 

Where tents are impossible, and they are for 90 per cent of con- 
sumptives, a back porch, a sheltered place outside in summer and under 
an open window in winter, can easily be secured, and they will work 




Fig. 51. Tent with Ventilator at the 
Top, for permanent out of door living. 



i8o 



CONSUMPTION. 






wonders. It is not the tent that cures; it is being out in the best air, 
the purest air than can be procured. It is possible to protect against all 
sorts of low temperature by having enough bedding. A consumptive 
must get the best air all of the time, not part of the time, but all of the 
time. Good fresh air in the daytime and vitiated bad air of the house 
at night is not half treatment; for the germs make more headway at 
night than the patient did in the daytime. 

There is no doubt that sanitarium treatment is best for those who 
can afford it. Because there is discipline there, and things must be done. 

There is no interference with the ar- 
rangements of a home or with the 
comforts of others. The treatment is 
continuous and is thorough. But the 
patient should not go alone if inclined 
to worry or to homesickness. That will 
interfere with his rest of mind, which 
is absolutely necessary to a cure. 

In the ordinary out-of-door life of 
a patient during the day, it is easy 
to provide a sheltering wall or shield 
from the wind. It should be thorough- 
ly exposed to the sun and have the 
direct rays of the sun shine upon 
the patient. Sunlight and fresh air 
will do more towards effecting a 
cure, even in a locality that is theoretically bad, than the absence of 
them in the best climate in the world will do unaided. This is to be 
borne in mind with relation to those cases where a patient cannot avail 
himself of good climatic conditions. Where it is possible to secure alti- 
tude in addition to dryness of climate, a height of from 3,000 to 6,000 
feet is desirable. This is helpful because the rarity or thinness of the 
atmosphere at that elevation obliges the patient to breathe with all of 
the available lung machinery in order to get enough air. That keeps the 
lungs well exercised and exposed to the action of the air. But weak 
heart and high pulse indicate that a high location be not chosen. There 
are scattered now all over the country numerous good sanitariums which 
are doing splendid work in curing patients and in stopping the spread 
of the disease. Where such results can be shown by the methods herein 
advocated, cures of 72 per cent in incipient cases and 46.11 per cent in 
advanced cases, there is much to be hoped for even in home treatment. 




Fig. 52. Clothing and Bed Ar- 
rangement for a Child to Sleep 
in, on a Porch. 






DIET. 



181 




Fig. 53. Suggestions for the Care 
of a Child in any way pre- 
disposed to Consumption. 



Diet. — The matter of diet is to see that the patient eats plenty of 
nourishing food. This is not so much a matter of appetite as of seeing 
that he eats enough. There are at least six meals a day. Not much 
food is to be taken at a time; but be sure that there is plenty of it. If 
the weight of the patient can be kept 
increasing, that is a sure sign that the 
ravages of the bacilli are being checked. 
Milk, eggs, fat meat, and hard bread 
are the chief articles of diet. The aim 
is to have the patient eat six meals a 
day and to drink three quarts of milk 
and to eat a dozen raw eggs besides. 
All of the food is to be well chewed, 
even the milk is to be sipped and moved 
back and forth in the mouth so that it 
is practically digested before it is 
swallowed. In this way it will not 
curdle nor will it make the patient 
bilious. Such are the principles of 
diet. But a more extended course 
with greater variety may be given. The patient's digestion must be 
moderately good to follow such a diet as is here suggested : — 

Before rising he may sip a cupful of hot milk. Sipping is essential 
to good digestion of milk. Rest for fifteen minutes. Then bathe and 
dress. 

Breakfast : Oatmeal or other nourishing cereal, to be well chewed. 
A chop or small steak. Dry toast. Tea or coffee if vised to it and it does 
not make him irritable. An orange or other fruit. 

Light luncheon between breakfast and midday meal : Cup of broth. 
Piece of toast. A glass of koumyss. A scraped beef sandwich. Eggs 
raw or cooked. Sherry or red wine; or a glass of good Scotch or rye 
whisky if desired. 

Midday dinner: Soup, preferably a thin soup. Really fresh fish. 
Roast or broiled meat. Vegetables : potatoes, string beans, macaroni, 
spinach, asparagus. Sherry or whisky and water. Cornstarch or rice 
pudding. 

Light luncheon in middle of afternoon: Similar to mid-morning 
luncheon. 

Supper: Arrowroot. Eggs. Stewed oysters and toast. 



182 



CONSUMPTION. 



Evening luncheon before going to bed : Cup of broth. A glass of 
koumyss. Cup of hot milk. Curds and whey. 

This or any diet must be supplemented by all possible aids to diges- 
tion, such as pepsin, pancreatin, taka-diastase. The bowels must move 
regularly. The size of the meals must be regulated according to the 
patient's condition. If he has spent a restless night he has not much 
nervous energy left. Therefore the meal must be a light one. If it has 
been restful he can digest a heartier meal. If the tongue is coated or 
foul, the amount must be lessened. It is upon such matters as these that 
the physician's advice must be sought and rigidly followed. 




Fig. 54. Arrangement of the Bed in a Room with Two Windows — 
both wide open. 



Exercise. — If the area involved is small and the general and mus- 
cular health of the patient is good, he may take gentle exercise, but 
under no conditions become fatigued. If the lung- area affected is large 
or if the patient's health is below the average, he does not want exercise. 
Exercise causes heavy breathing. The lungs of a consumptive are 
wounded. No one thinks of working a sore hand or foot to make it 
heal. They let it rest. That is what must be done by the consumptive. 
He must let his lungs heal. It is infinitely better for such to sit around 
in the sunshine and fresh air conserving all of the energy they have and 
devoting it to the digestion of as much nourishing food as possible. If 
such feel the need of exercise it is best given in the form of massage. In 
cases where the ambition of a patient exceeds his discretion, and he wants 



LIVING OUT OF DOORS. 



183 




Fig. 55. Securing a Supply of Fresh 
Air by opening all of the Windows. 



to walk miles, and play golf over long links as he used to do, that is 
where the discipline of a good friend or doctor comes in. Every time 
a patient gets tired he undoes all that has been done towards gaining 
resistance to the ravages of the disease. One indiscretion in that direction 
puts him back several weeks. Rest 
for the body and rest for the mind; 
freedom from worry and the cares 
of business, will be absolutely neces- 
sary to a cure. Everything should 
be dropped and the attention con- 
centrated upon the cure. 

How to Live Out of Doors. — 
It is presumed that the patient has 
selected the driest possible climate 
for outdoor life. To those who can 
afford to go to a sanitarium, there is 
little to be said further than to go 
there is quickly as possible. It is to 
those who cannot, as well as to 

those who are curious to know what is the modern practice of curing 
consumption, that these directions are given. There is first a tremen- 
dous prejudice to be overcome about taking cold. That is the great 
bugbear in the way of the ready and universal adoption of the methods 
here advocated. Let it be said as convincingly as possible at the outset 
that you will not take cold as readily or as frequently if you adopt the 
outdoor life as you will if you follow the indoor life. Besides if you 
have consumption and continue to live indoors, with a little outdoor life 
in the warm part of the day, you will die. If you live outdoors summer 
and winter, night and day, fine weather and bad weather, you will get 
well. Forget all that you have ever heard about draughts, chills, and 
night air, and do as thousands are doing while you are reading this, 
and get well. 

You are not to suffer the least discomfort in following the outdoor 
living. If you do, you are not doing it right. In fact, if you do not 
feel better out of doors than you do indoors, there is something wrong 
in the way you are trying to do it. 

Shelter. — You are not to sit out exposed to the wind in winter or 
to the intense heat of the sun in summer. You are to be made as com- 
fortable as possible. While you are to be out of the wind you are not 



184- 



CONSUMPTION. 




Fig. 



56. How to Dress for Out of Door 
living in Cold Weather. 



to be away from the direct influence of the fresh air and of the sun. 
The fresh air and the sunshine are what you are outside to get, and if you 
do not get all that you can, you are only half doing your share. 

First of all, get a comfortable chair. Remember that you are going to 
sit many hours a day in that chair, and it must be as restful and snug as it 
can be made. A rolling chair or a wheel chair is very desirable, because 
it is so easy to move about as the wind changes, or as the sun changes, or 

when you desire to change the 
scene. Besides, with such an easy 
chair to move, you can often wait 
upon yourself when it is not con- 
venient for others to do so on the 
moment. An adjustable reclining 
chair is very good, as it places one 
at the comfortable angle and will 
take a larger and softer cushion. 
Or a canvas chair, which fits it- 
self so well to the shape of the 
body, is restful. The cushions 
of the chair are to be as soft and thick as can be provided; a mattress 
is often desirable, and can be adapted to a large chair very effectively. 
A table or book rest is indispensable for reading and writing; for 
writing is indulged in even when the thermometer is at or below zero, 
and when the ink freezes at the point of the fountain pen. 

If the house has broad porches or verandas, one can always find a 
sheltered spot in any weather on the lee of the house. But even there 
a screen, such as must be provided in the absence of porch room, is con- 
venient. If this is of glass, so much the better, as it will not cut off 
the sunshine. This does not mean the complete walling-in by glass, but 
is only a small shield against the wind. In a shut-in porch, with glass 
all about, one is little better than when in a room. If glass is not pro- 
curable, any form of shield will answer. It should be easily movable, 
not too heavy, and yet not light enough to blow down in the wind. 

Clothing. — Again the rule is : be comfortable. It is not intended 
in the outdoor cure that the body shall be cold. That is not what cures. 
Cold air is good not because it is cold but because it is dry. Dry air is 
just as curative in summer as it is in winter. Remember that you are 
living where you can get the freshest of air all of the time. As long as 
that fresh air gets free and abundant access to your lungs that is all 



CLOTHING. 



185 



that is needed. Comfortable clothing is easily enough secured in the 
summer and while it is warm ; but the comfort on cold stormy days is a 
matter of experience. It is not right to go out for a little while improp- 
erly or insufficiently clad, get chilled, and then come in to a warm fire to 
get warm and then to go out again. That means that you sit beside a 
warm stove until the pores of the skin open; then when you go out to 
the cold air again, the pores are suddenly closed, and the result is a chill 
and a cold. You are not taking much exercise while you are out, so 
it is necessary to be well clad. Right here you must be careful to remem- 
ber that weight of clothing and 
warmth of clothing are not to be 
confused. Do not rely upon heavy 
underclothing, but upon warm out- 
side wraps. It is from them that 
the protection will best come. The 
material of which they are made is 
of little importance; but it is of the 
greatest importance that they be 
warm enough. That is the only test 
of their fitness. A loose fitting outer 
garment is not so warm as a rather 
tight fitting one. It should fit close 
at the wrists so as not to allow the 
cold air to affect that particularly 
sensitive part of the body. A high 
collar, or, better still, a cape will be 
found of great service in keeping 
the neck warm. 

Women will find a small shawl a sufficient covering for the head. 

Men should have a cap with flaps to pull down over the ears and a 
peak to keep the sun from the eyes is desirable. 

The hands are best protected by mittens. Gloves separate the fingers 
and are not nearly so warm. A pair of cotton gloves of large size may 
be worn under warm woolen mittens. This is found to be a very com- 
fortable arrangement. 

The feet should be protected by loose-fitting, comfortable shoes. Two 
pairs of woolen socks or stockings are warmer than one thick pair. The 
very great value of newspapers as a means of keeping out cold and of 
keeping in the warmth of the body must not be forgotten. These can 




Fig. 57. Sleeping in a Room with 
only One Window. The Head of 
the Bed is placed outside of the 
Room, in the Open Air. 



1 86 



CONSUMPTION. 




be placed over the chest, the back, and around the feet, with great advan- 
tage. 

Sleeping Out of Doors. — The most satisfactory results are secured 
from sleeping in a tent. This is pretty generally the methods of the best 

sanitariums. Perfect shelter and protection 
against all kinds of weather is secured by its 
use. The ventilation is provided by the pas- 
sage of the used air out at the top. Such a 
form as that shown in Fig. 51 is a standard. 
But shape has little to do with it. 

A porch may easily be fitted up with pro- 
tective awnings so as to form an ideal sleeping 
place, free from exposure to weather and to the 
curious. 

Many houses have upstair porches or bal- 
conies, which afford abundant shelter with a 
little added sense of security. 

Where such conveniences cannot be obtain- 
ed, one must fall back upon indoor sleeping 
with full ventilation. If there are more than 
one window in the room, close the door, so as 
not to affect the rest of the household, and 
open all of the windows. The arrangement of the room under such 
conditions is shown in Fig. 54. 

Where there is only one window available, there are several ways 
of arranging. One is nothing more nor less than putting the head of 
the bed out of the window. Where shelter against observation is desired, 
an umbrella may be raised, but awnings or screens will be better. Care 
must be taken that not more than one-third of the length of the bed is 
permitted to project, as there would be danger of the bed tipping if more 
were used. A weight may be attached to the lower part for additional 
security. 

A convenient sort of platform is arranged outside of the window upon 
which the mattress is placed. The inner part is built up to the required 
height so that the bed is on a level with the shelf. 

As a last resort, when no other accommodations are at hand, raise the 
window to the full height and place the bed directly under the window. 



Fig. 58. A Shelf or Sup- 
port OUTSIDE OF THE 

Window upon which 
the Head of the Mat- 
tress MAY REST. 



DETECTION OF DISEASE 187 

DETECTION AND RECOGNITION OF DISEASE. 

The first step in the detection and recognition of disease is a care- 
ful and thorough study of the patient. Do this in all cases before 
looking for the symptoms under the head of any disease. There is 
a very decided suggestion of symptoms which do not exist when one 
reads a printed list of them. Writers of patent medicine advertisements 
know this effect full well, and take advantage of it to the utmost in 
preparing their matter. Jerome K. Jerome, the English humorist, gives 
a ludicrous description of his own sensations when he studied a medical 
encyclopedia from A to Z and found that he was suffering acutely from 
every disease but one mentioned in it. 

Let the mind be perfectly free from all suggestion or prejudice and 
write down a list of such conditions as seem to be most marked. Do 
this leisurely and carefully from your own observation and the assistance 
of the patient's complainings. Then, but not till then, consult the list 
of symptoms arranged for ready reference on page 206. Suppose, for 
illustration, there is a fever of 102 degrees shown by the thermometer; 
bad breath; breathing through the mouth; difficulty in swallowing; and 
a chill has preceded the fever, On looking up these in the list of symp- 
toms beginning on page 206, it will be found that tonsilitis or inflamma- 
tion of the tonsils is the only disease which appears in every list of 
diseases under all the symptoms mentioned. By referring to that disease 
on pages 336, 337, and 338, one's suspicions are confirmed. 

In order to facilitate the search for symptoms, one must be familiar 
with the details given in the following pages, where the appearance 
of the several parts of the body under disease is clearly given. Such 
aids as the thermometer and the ability to use it should always be at 
hand. 

A casual glance at symptoms of diseases will show the very great 
number of cases in which an increase in temperature is an early indication 
of disturbance. The taking of the temperature is one of the first things 
to be attended to in cases of illness. If fever is present, one can easily 
determine the severity of it by the degree indicated on the thermometer. 

The condition of the pulse, the presence of pain, the appearance of 
the tongue and eyes, the presence of any eruption, the condition of the 
skin, the nature of a cough, are a few of the subjects which should 
receive attention. 

The necessity of a careful study of all of these conditions cannot be 
too deeply impressed. For this is the starting point of the application 



1 88 DETECTION OF DISEASE. 

of intelligent assistance. As an accomplishment, there is nothing to 
equal it in other lines of education, for nothing else brings so fully 
into play the exercise of the benevolent affections for the relief of the 
suffering. 

One must not be deterred from approaching the subject of detecting 
and recognizing disease on account of the proverbial difficulty of making 
a correct diagnosis. Because there are certain aspects of the study 
that are beyond the skill of experienced physicians, is no reason why 
one should decline to go as far on the road as one's opportunities and 
ability will permit. 

It is a very decided step in advance to be able to distinguish between 
states of severe illness and simple indisposition ; to know whether or not 
a patient requires the services of a skilled physician ; to be able to detect 
the onset of dangerous and infectious diseases ; and to minister to the 
wants upon such general lines as may abort a threatened attack. All 
of this is quite within the range of possibility for persons of ordinary 
intelligence to do with a fair measure of success. 



WARNINGS OF DISEASE. 189 

PRODROMAL SYMPTOMS OR WARNINGS 
OF DISEASE. 

Disease is any deviation from a state of health, and is always preceded 
or accompanied by certain well-marked symptoms of its approach or 
presence. Those which precede it are called "Prodromal Symptoms/' 
because they are forerunners to warn us of an impending attack. They 
come as warnings to us, often very timely, and we may ward off an attack 
or succumb to it, according as we heed or ignore them. Some of these 
symptoms are very plain and can be detected by us all ; others require not 
only a practised eye to observe, but a mind trained by long experience to 
recognize the diseased condition which they indicate. It is one 
thing to read the sign and another to understand it. There are, then, a 
number of symptoms which are beyond us to interpret correctly; but 
there are a great many that we can all see and understand. It is the 
latter that we should learn in the interests of the comfort, well-being, and 
even the life of ourselves and others. 

There are two broad classes of symptoms. First, those which the 
sufferer alone knows about, called "Subjective Symptoms" ; and, second, 
those that another person can see, called "Objective Symptoms." The 
first class is the one about which the physician asks his patient so many 
questions. Upon correct and exact answers to those questions much 
depends, and care should always be taken to give the doctor a clear under- 
standing of the nature of the pain, its location, and other details. Do 
not withhold any information from him. The more you can tell him 
about this class of symptoms the better for you. Very young children, 
of course, are unable to help in this way, and it is necessary to work upon 
the second class of symptoms, or to be aided by the child's sign language, 
which is often helpful. 

The second class of symptoms, the Objective, are really signs of 
disease because they are visible and can easily be read correctly by an 
observing person. 

General Appearance. — There is a certain indefinable something in 
the appearance of one who is threatened with disease which suggests that 
he "is not well." Closer observation and attention to detail will inform 
us that this general appearance of ill-health is made up of a number of 
separate indications which can be noticed individually, and which, put 
together properly, will lead to what the doctor calls a correct "diagnosis" 
or reading of the disease. An intelligent understanding of these warning 



190 WARNINGS OF DISEASE. 

signs will prevent us from committing one of two serious mistakes : 
either magnifying every slight ailment, and thereby needlessly alarming 
both the patient and ourselves, or neglecting to summon medical assist- 
ance in time. 

In studying the details of the case, we endea\~or to find out in what 
way the changed appearance has come about. We are so familiar with 
the normal and usual appearance of those in our own families that we 
should be able to detect any change that may come to one of its members. 

The Face. — Sudden paleness may be a sign of fainting, or of an 
internal or external hemorrhage. 

Constant paleness is a sign of anaemia, insufficient blood. 

A flushed face is a sign of feverishness, and calls for the use of the 
thermometer. 

A livid or bluish appearance of the face and lips indicates a disturb- 
ance in the breathing or in the circulation of the blood. There is also 
a possibility of congestion of the brain. It is also present in choking. 
suffocation, whooping cough, and in the presence of a foreign substance 
in the throat. 

Distortions of the face are caused by pain in any part of the body, 
and vary with the intensity of the pain. Very marked distortion of the 
features is an indication of convulsions, epilepsy, hysteria, St. Vitus's 
dance, and paralysis. 

A peculiar dark blush is noticeable in pneumonia. 

Eruptions, appearing first upon the face, may be measles, German 
measles, or other eruptive fevers. 

The lips are drawn and surrounded with a white ring or zone, the 
ears are cold, the eyes hollow, and sometimes the muscles of the face 
set, in the severe pains of peritonitis, inflammation of the bowel (peri- 
toneum) . 

In cases of hysteria one is struck by the peculiar woe-begone expres- 
sion of the patient's face when the symptoms are under discussion, and 
by the rapidity with which the expression changes when the mind is 
diverted into a different line of thought. 

There is the brightness of the eye, which is seemingly on the alert to 
catch any sign of hope of recovery, to be remarked in patients suffering 
from advanced phthisis, and the pale, emaciated face is in marked con- 
trast to the deep hectic flush over the cheek bones. 

Again, in people suffering from kidney disturbances, one notices the 
peculiar doughy appearance of the face and the puffiness under the eyes; 



OBJECTIVE SYMPTOMS. 191 

a physician will often make several examinations of the urine before he 
finally is able to confirm his suspicions which were aroused by these same 
symptoms. 

When a patient is seemingly indifferent to all surroundings, or mut- 
ters in delirium, the face being expressionless, we find the case one of low 
running fever. 

The Tongue. — We all know that almost the first thing a physician 
does is to ask to see the tongue. Florid redness is a sign of dyspepsia ; 
a livid or purple tongue shows that there is obstruction of the circulation, 
or of respiration; a pale or white tongue denotes a weak and impov- 
erished state of the blood; a furred tongue is common to some people 
even when in health, but, when there are bright red points beneath the fur, 
scarlet fever may be present ; a tongue with red edges and furred in the 
middle is a sign of intemperance or indicates brain disorder. In feverish 
conditions of the system, the tongue becomes very dry and hot, or 
parched ; when the tongue is clammy and viscid, there is usually derange- 
ment of the digestive functions; a yellow tinge on the coating of the 
tongue indicates a biliary or liver disorder ; a thin, creamy white coating, 
inflammatory disease in the abdomen. In sore throat we often find the 
tongue of a dingy, whitish color; in scarlatina, we have elongated 
papillae, appearing as bright red spots ; and in some forms of intestinal 
irritation and hemorrhage, and after acute disease, it is clean and bright 
red. In anaemic patients, we find this organ partaking of the general 
condition of the system, being pale and flaccid ; in paralysis, it is drawn 
on one side ; in delirium tremens and nervous affections, it is tremulous ; 
and in some stages of typhoid fever it becomes almost black and cannot be 
protruded. 

The Gums and Lips are also indicative of certain conditions of the 
system : — 

When the gums are swollen, and bleed at the slightest touch, there 
is reason to believe that the system is generally out of order, in a state 
commonly called scorbutic (scurvy). Swollen or spongy gums are also 
a sign of disorders of digestion, of certain types of anaemia, and of 
diabetes. In ulcerative stomatitis, we have ulceration along the gum 
line. Anaemic patients have pale gums. Different poisons produce dis- 
coloration of the gums. Lack of cleanliness is not an uncommon cause 
of redness along the edge of the gums. 

Copper poisoning causes the gums to have a greenish-blue line at 
the edges, while a pale bluish-red gum, with a marked line of blue at 



192 WARNINGS OF DISEASE. 

the edge, is a sign that lead has been taken into the system in some way. 
In mercurial stomatitis a blue or red margin is found, and scurvy pro- 
duces a purple coloration. 

The Lips. — When the lips are parched and cracked, with fetid 
breath, there is reason to suppose that fever is present in a typhoid form, 
though this is by no means a certain sign in itself. Pale lips often suggest 
anaemia and other diseases in which the skin is pallid, and often the first 
symptoms of cardiac (heart) disease is detected from their blue color. 
Trembling or twitching of the lips may be caused by paralysis, severe 
pain, or emotion. A common symptom of epilepsy is a foam on the 
lips. 

The Eye. — The eye is a valuable indication of nervous condition 
and affections of the brain. 

Contraction of the pupil of the eye occurs in paresis (slight paralysis), 
locomotor ataxia, meningitis, tumor of the brain, etc. 

Dilation of the pupil occurs in epilepsy, hysteria, paralysis of the 
third nerve, paresis, and locomotor ataxia. 

Unequal size of the pupils is also noticed in paresis, locomotor ataxia, 
and nervous diseases of the iris. 

The filling of the eyes with tears and the accompanying inflamma- 
tion, which precede influenza or "cold in the head," and measles, are 
familiar. 

Excess of bile in the system is indicated by the greenish-yellow color 
of the "white" of the eye. 

Trembling eyelids indicate extreme nervousness. 

Rolling of the eyes accompanies convulsions and other spasms. 

The Pulse is one of the chief indications of disease. When the pulse 
is large, rapid, and soft, it indicates the early stage of fever or of acute 
inflammation, as in scarlatina, erysipelas, inflammation of the lungs, etc. 
When very frequent, large, and hard, it accompanies the full onset of 
fever, of an inflammatory kind, such as rheumatic fever, smallpox, etc. 
A moderately frequent, large, and hard pulse may be that of mere fullness 
of blood. When frequent, hard, large, and thrilling, there is generally 
some disease of the artery, or in its close neighborhood, such as aneurism 
or tumor. A frequent and small pulse is often met with in consump- 
tion, in which the quantity of blood is diminished, and is equally im- 
paired. A slow, laboring, large, and hard pulse is often attendant upon 
apoplexy or other forms of pressure on the brain. 

Fever is indicated by a rise in temperature above normal (98. 2°) and 



DISEASES OF THE HEART. *93 

can be ascertained only by use of the clinical thermometer. The degrees 
of fever are: — 

Feverishness, .99° to ioo° 

Slight Fever, ioo° to 101 

Moderate Fever, 101 ° to 103 

High Fever, 104 to 105 ° 

Intense Fever, 105 to 106 

Highest Fever, 106 and over. 

Diseases of the Heart. — The heart, from the important part it plays 
in the animal economy, is subject to various serious, and often fatal, 
diseases. The ear is the principal means of obtaining a knowledge of 
the state of the heart, and by auscultation and percussion we are enabled 
to detect the existence of various diseases. The heart gives out two 
sounds, known as the first and second, which are distinguished from each 
other. The first sound is longer than the second, and the interval 
between the first and second sound is shorter than that between the second 
and first. They have been compared to the two syllables, lupp, ditpp. 
Any manifest alteration in these sounds is indicative of the existence of 
disease. They may be high or low, clear or dull, muffled, rough, inter- 
mittent, etc. Murmurs or regurgitant sounds may arise from disease of 
the valves. The power of distinguishing between the normal and abnor- 
mal sounds of the heart, and of the causes producing the latter, can only 
be obtained by lengthened experience. Diseases of the heart are usually 
divided into two classes : first, functional or nervous : and, second, struc- 
tural or organic. Chief among the former are palpitations, syncope or 
fainting, and angina pectoris. They are chiefly to be met with in per- 
sons of a naturally nervous temperament, more especially women suffer- 
ing from hysteria, or other like complaints, and may be induced by great 
mental excitement. In such cases great attention should be paid to the 
general health, using tonics, sea bathing, and gentle open air exercise, 
to strengthen the system. Violent exertion, and strong mental excite- 
ment, are particularly to be avoided. Among the principal organic dis- 
eases to which the heart is subject are pericarditis, carditis, endocarditis, 
atrophy, hypertrophy, dilation, and valvular diseases. 1 

Disease of the valves so commonly follows endocarditis, if of long 
continuance, that it may almost be considered as a chronic form of that 
disease. It is a thickening of the internal lining of the heart, especially 
at the valves. It becomes not merely thickened uniformly, but is the 
seat of warty excrescences, and even cartilaginous and osseous formations 



194 WARNINGS OF DISEASE. 

of considerable size, extending into the cavities of the heart. In old 
persons, and especially those addicted to a generous mode of living, we 
most frequently meet with ossification, the effects of which are congestion, 
difficulty of breathing, apoplectic seizures, and other symptoms of embar- 
rassed circulation. 

Breathing. — The normal rate of breathing is about eighteen respira- 
tions per minute for men, slightly more for women, and still more for 
children. Difficulty in breathing may result from obstruction of the 
air passages, pressure upon the lungs, diseases of the lungs, swelling of 
the abdomen, heart disease, asthma, anaemia, hemorrhage, or paralysis 
of the muscles of the chest and thorax. If difficulty occurs while breath- 
ing in, there may be a foreign substance in the larynx or trachea. If 
it occurs on breathing out, there is probably loss of elasticity and tone 
of the air vesicles in the disease known as emphysema. It is most com- 
mon in a combination of the outward and inward acts of breathing. 

If difficulty in breathing takes the form of shortness of breath, not 
due to exertion, it indicates severe heart or lung disease. If it is due 
to exertion it is not serious, but may indicate weakness, anaemia, or 
stoutness. 

Slow difficult breathing occurs in the coma or insensibility of diabetes. 

Rapid difficult breathing is noted in inflammation of the lungs, pleu- 
risy, pain in the chest muscles, fever, heart disease, anaemia, and diseases 
of the base of the brain. 

Irregular difficult breathing, now fast, now slow, is serious, and 
occurs in apoplexy, meningitis, tumor in the brain, fatty degeneration 
of the heart, and other similar diseases. 

In labored breathing, such as is seen in diphtheria and croup, it 
seems as though every muscle of the chest was brought into play. 

Interrupted, wavy, or cog-wheel breathing is a broken or inter- 
rupted breathing inward, caused by nervousness, unequal or irregular 
contraction of the muscles of the chest; or irregular expansion of the 
lungs from disease. 

Suppressed breathing is the entire absence of the breathing sounds. 
It occurs when the lungs are filled with the water or effusions in pleurisy, 
or in other solid conditions of the lungs. 

Mouth breathing indicates a stoppage in the nasal passages, usually 
by adenoid growths. 

The irregularities of breathing and the condition of the lungs are 
indicated to the physician by use of an instrument called a stethoscope, 



COUGHS. 



195 



which he places against the walls of the chest, front and back, with the 
ear-pieces to his ear. The breathing sounds are magnified or intensified, 
and reveal the condition of the lungs. Very often the examination by 
auscultation, as it is called, is conducted by placing the ear against the 
chest walls, by which means the sounds can be heard. The examination 
is still further assisted by tapping the fingers placed upon the chest so 
that a sound is made over the lungs which tells the state of the lungs. 
A hollow sound is given by those parts of the lungs that are filled with 
air and consequently are in good condition, while those parts which give 
a dead, dull sound are filled with water, pus, sputum, tuberculous, or other 
matter, and are, consequently, inactive and diseased. The tapping exam- 
ination is known as percussion. 

Coughs. — A cough may be the result of various conditions, but one 
of the most common causes is a severe cold upon the lungs. The air 
passages are lined by a thin, delicate mucous membrane which contains 
secreting glands, that in health secrete a small amount of fluid mucus 
to assist the air in passing in and out of the alveoli of the lungs without 
annoyance or friction. If, for any reason, as taking a sudden cold, this 
secretion is checked, the air passages become dry and inflamed, and pro- 
duce a disagreeable sensation which patients sometimes call a smarting 
of the lungs. This state of dryness lasts usually but a short time, and is 
followed by a secretion many times more abundant than natural. This 
increased secretion, owing to inflammation of the mucous glands, is 
catarrhal in character, and acts as a constant irritation. It is often thick, 
yellowish in color, and raised with difficulty. A persistent cough is 
Nature's desperate remedy to expel the hardened, thick, offending mucus, 
just as if a bread crumb or some other foreign substance was in the wind- 
pipe. By fits of coughing Nature endeavors to obtain relief. This 
offending substance must be removed, and Nature has only two methods, 
one to throw it up by coughing, the other to absorb it into the circulation ; 
the former method is much more desirable than the latter. When a 
catarrhal cold is yielding to treatment, the mucus becomes loose, is easily 
detached and readily expelled, all the symptoms become more favorable, 
and the cough less racking and severe. As the secretion is gradually 
reduced to the normal, the inflammation and irritation subside, the cough 
more and more disappears. 

Great harm may be done by suppressing a cough when Nature is 
striving to free the air passages from an overload of mucous secretions. 
Giving opium or morphine, cough drops, troches, or any anodyne reme- 



196 WARNINGS OF DISEASE. 

dies to a young child whose air passages are loaded with catarrhal debris 
is bad practice, and has cost many a little sufferer his life. In no instance 
must the cough be quieted in an infant suffering from catarrhal diseases, 
no matter how much the mother and others are annoyed by the persistent 
coughing. In capillary bronchitis the cough is the child's safety, and 
must not be suppressed, else the lungs will fill up and the child will die. 

Coughs due to irritation and a dry inflammation of the bronchi may 
be safely quieted, and this can be done with positive benefit to the patient. 

There is a great deal of character about a cough, and to the prac- 
tised ear much information as to the cause and location of disease is 
conveyed. 

The barking, ringing cough of spasmodic croup is readily recog- 
nized by any who have heard it once. 

The dry, hacking cough occurs in the early stages of inflammatory 
disease and is a sign of obstruction in the respiratory region. 

The stomach cough is caused by reflex action from a diseased or dis- 
ordered stomach, and is not accompanied by expectoration. 

The short, teasing cough denotes irritation of the throat. The dis- 
ease is seldom deep seated. 

The hoarse, smothered cough is indicative of obstruction in the 
larynx and is a serious symptom. 

The cough of influenza is dry, irritative, persistent, and annoying. 

The short, harsh, ringing cough of pneumonia is tight, and is sup- 
pressed by reason of the pain which accompanies it. 

The spasmodic, paroxysmal, short, rapid cough of whooping cough, 
terminating in the deep, loud, crowing inspiration, from the sound of 
which the disease takes its name, is familiar. Vomiting frequently 
attends the violent and exhausting effort. Three such attacks form one 
series. 

Expectoration. — The act of discharging mucus or other matter from 
the throat, lungs, or trachea, and the substances so discharged, are called 
the expectoration. The term in its first meaning is synonymous with 
coughing, and need not further occupy our attention; but, in its second 
sense, we find so many important considerations connected with the 
diagnosis of disease, that we must pause awhile to consider it. It is 
by the nature of the expectoration that the physician is enabled to judge 
of the character and progress of the malady with which he has to con- 
tend. If such expectoration is frothy, it indicates active bronchitis, 
catarrh, or influenza ; if stringy, and of a whitish or yellowish color, the 



EXPECTORATION. 197 

bronchitis has become chronic, or spasmodic, or there may be whooping 
cough present, or impending ; if purulent it may indicate the latter stages 
of catarrh or influenza, especially if the sputum, or matter expectorated, 
is mixed more or less with a tenacious mucus; genuine pus, capable of 
being poured from one vessel to another, indicates the bursting of an 
abscess in the lungs, or of pus from empyema, which has found its way 
into the bronchial passages; the yellow matter often expectorated in 
humid asthma is not truly purulent, but to a large extent mucous. If 
lumpy, there can be no mistake as to the nature of the disease; pulmo- 
nary consumption has fairly set in and made considerable advances; 
there is sure to be a softening and breaking up of tubercles, where 
there are small yellowish or whitish lumps expectorated along with a 
clearer fluid on which they float, perfectly distinct. If membranous, 
the sputum indicates inflammatory action of a chronic, most likely of a 
croupy, character. If stringy, and rusty colored, there is certainly 
pneumonia ; if bloody, there is hemoptysis, — either a blood vessel of the 
lungs has broken, or blood has oozed through the bronchial membrane, 
both of which are symptoms indicative of great danger to the patient. 
If offensive and putrid, there may be gangrene of the lungs, but this 
is only a single sign of such condition and not to be relied on alone. 

These are the distinctive characters which expectoration assumes; 
its increase or decrease in bulk or density, its varieties of tint, and other 
particular changes, tell to the experienced eye of the doctor how the 
case is progressing, and whether it is likely to terminate in convales- 
cence or death. 

The Skin. — The condition of the skin is indicative not only of the 
several diseases of the skin, but of eruptive, and other functional and 
constitutional diseases. 

Symptoms of skin diseases are : heat, pain, smarting, tingling, 
burning, and itching. 

Redness, heat, and burning are indications of ordinary chafing, such 
as occurs in infants and in very stout persons, on those parts of the 
body which rub against one another. 

Very small puffy elevations of the skin accompanied by itching, 
burning, and prickling sensation denote hives. 

Heat, swelling, redness, discharge, and crusting denote eczema. 

German measles appears as an eruption of rose-colored spots of 
pinhead size, seen generally on the face at first, though it is often 
noticed earlier on the roof of the mouth. The eruption appears 



198 WARNINGS OF DISEASE. 

from the first to the fourth day of attack and disappears within a 
week. 

Measles shows itself as an eruption on the third or fourth day of 
attack, in the form of dark-red or purplish spots, of small size, first 
upon the face and then spreading over the body. Clear patches of skin 
are visible between the collections of spots. The eruption lasts about 
nine days. Behind the ears, on the forehead, and face are the first 
places to look for them. 

Scarlet fever eruptions take the form of a bright scarlet rash which 
first appears on the chest and neck, and spreads rapidly over the entire 
body. The eruption is not raised, but is quite flat or even with the 
surface of the skin. It disappears on pressure and seldom lasts more 
than five days or a week. 

Chicken pox shows distinct, scattered, slightly raised, flat spots 
some of which change to blisters. They come in successive crops and 
disappear in from three to five days. The eruption is accompanied by 
intense itching. 

Erysipelas appears in the form of red spots which quickly run 
together and form a crimson or violet colored section, with a distinct 
border. There is swelling, tingling, heat, and tenderness. 

The skin shows increased sensitiveness (hyperesthesia), decreased 
or absent sensitiveness (anesthesia), and perverted sensitiveness (pares- 
thesia), in nervous diseases. 

The Stomach. — The symptoms affecting the stomach are vomiting 
or nausea, flatulence, pain after eating, and, in some cases, eructations 
of a watery fluid, in large quantities. 

Vomit. — Bilious vomit is of a greenish-yellow color owing to the 
presence of bile. 

Black Vomit is characteristic of cholera and is composed of blood 
and the contents of the stomach. 

Coffee ground vomit is composed of blood from the stomach mixed 
with the contents of the stomach, and occurs in forms of cancer of this 
organ. 

Continuous vomiting is very serious by reason of its violence and 
long continuance. It often occurs in pregnancy. 

Stercoraceous vomiting is that form in which some faecal matter 
appears. It is a symptom of intestinal obstruction. 

The Bowels present the following symptoms when disordered: — 

Constipation may arise from torpor of the bowels, owing to long 



F7ECAL MATTER. 199 

continued neglect, or to the absence of suitable articles of diet, or from 
deficient secretion of the natural stimulus, the bile. 

Diarrhoea consists in an increased discharge of liquid faeces, and 
may be caused by the irritation of food or medicine, or by the presence 
of hardened faeces ; or sometimes from a poison disease, such as cholera. 

The Faeces. — The faeces are the rejected residue of the food after 
it has served the purposes of nutrition. According to Berzelius, the 
normal constituents of the human faeces are as follows : — 

Water 73.3 

Vegetable and Animal Remains 7.0 

Bile 0.9 

Albumen 0.9 

Peculiar Extractive Matter 2.7 

Salts 1.2 

Slimy Matter, consisting of Picromel, peculiar Animal 

Matter and Insoluble Residue 14.0 

This is the composition of the faeces when the health is perfect, and 
there is nothing very peculiar in the diet to render it otherwise. In 
disease great changes take place, not only in the proportions, but even 
in the ingredients of which the faeces a v re composed. By the peculiarity 
of smell and color, the medical man is enabled to judge of the nature 
and progress of certain diseases; therefore it is of importance that the 
faeces should be preserved for his inspection. The following are a few 
of their most obvious indications : — ■ 

Natural faeces are of a gingerbread color, slightly varying in tint 
and hue, and of tolerable consistency, although perfectly impressible. 
The smell is offensive, but has not that peculiar fetidity observed in 
some diseased conditions of the system. The evacuations should be 
daily, and at, or near, a certain hour; but a deviation from this rule is 
no proof of ill health. Cases are known of perfectly healthy persons, 
who went to stool only once in two, three, or four days, or even in a 
week. It depends greatly upon habit, but the habit of infrequency is 
not good. Children should be taught to attend to this matter at a 
certain hour every day, and the habit of a daily evacuation of the 
bowels once fixed, will probably remain through life, except when it is 
interfered with by sickness, or the failing powers which are often con- 
sequent upon old age. 

Mucous evacuations have a semi-transparent, jelly-like appearance. 
They may be tinged with brown, green, or yellow, all indicating the 



200 WARNINGS OF DISEASE. 

presence of bile; or red with blood, when there is inflammation or con- 
gestion of the mucous membrane, as in mucous diarrhoea and dysentery. 
Evacuations may have a rough, shreddy, or spotty appearance. There 
may be little irregular round specks, like dirty white of egg, scattered 
through the faeces, or long pieces like shreds of lymph or dingy colored 
parchment. In such cases there may be acute inflammation of the 
mucous membrane of the intestines, situated in any part of the bowels 
or rectum. 

Pus in the faeces indicates either ulceration of the bowels, or the 
breaking of an abcess into the alimentary canal. If there is much of 
it, the latter is most likely the case. This is a symptom of danger. 

Bile in the faeces indicates excessive action of the liver, the cause 
of which may be irritation or active congestion,— in which case the 
color is generally of a yellowish brown, but sometimes, especially in 
children, it is of a decided green color. This, too, is often the case 
with grown persons, when the liver is just recovering from a torpid 
state and beginning to act somewhat violently. This is commonly 
the case, too, in hydrocephalus, when the color is a peculiarly deep 
green. Bilious motions may or may not be loose, although they are 
generally so, from the bile acting as an irritant to the lining of the 
bowels. 

Absence of bile in the faeces is shown by absence of color. The 
motions are clayey, sometimes as pale as pipe clay, and ranging from 
that shade up to the natural hue, occasionally assuming a grayish tint. 
They vary in substance, and when liquid are usually frothy, and float 
upon water on account of the quantity of gas which they contain. 

Loose bowels result from so many causes that we cannot take them 
as clear indications of any particular diseases. An irritated or inflamed 
state of the mucous membrane causes diarrhoea, in some stages of which 
the stools are fluid. If, in this state, there are rice water stools, it 
indicates Asiatic cholera, or the too powerful action of saline or drastic 
purgatives. 

Hard, solid faeces, at unequal intervals, indicate constipation. 

Offensive stools occur in some forms of dyspepsia. The fcetor is 
excessive in low fevers, when the poison introduced into the system 
seems to render the whole of the solids and fluids thereof peculiarly 
liable to decomposition. 

The Urine. — The urine in a state of health is of an amber color, 
with a faint odor, slightly acid reaction, and a specific gravity of 1.018. 



CONGESTION OF THE KIDNEY. 201 

The average quantity voided in 24 hours is from 40 to 50 ounces, or 
from 2^2 to 3 pints. A greater quantity than this is passed just after 
the crises of fevers, when the pores of the skin are closed by cold or a 
chill, in diabetes, and in other kidney diseases. 

A less quantity is passed after excessive perspiration, in diarrhoea, 
congestion and inflammation of the kidneys, fever, and stricture and 
obstruction. 

Color. — If the quantity is increased, the color is usually very light. 
If the amount is diminished, it is usually darker. A clouded appearance 
comes to nearly all normal urine on standing for a time. It is due to 
mucus. 

Blood in the urine is a sign of congestion, inflammation, tumors, or 
injuries in the bladder or urethra. If it flows in the early part of the 
micturition, the urethra is affected; if at the latter part of the act, the 
bladder is involved. If mixed throughout, the kidneys are probably 
involved. 

Pus in the urine indicates suppuration at some point in the urethra 
or bladder. Its occurrence during the early or late parts of micturi- 
tion indicates the urethra or the bladder as the seat of the affection. 

Brick-dust deposits in the urine indicate an excess of the urates 
which are increased in wasting diseases, gout, fever, malaria, scurvy, 
indigestion, etc. 

Odor. — The odor of urine is changed by articles of food, such as 
asparagus, garlic, etc., and by such medicines as santonin. 

Congestion of the Kidney. — The attention of the patient is called 
to this disorder by pain over the kidney running into the genital organs 
and by a constant desire to urinate; by headache and nausea. The 
urine is scanty and high colored. In acute Bright's disease, dropsy is 
an early symptom; pufriness of eyelids and swelling of lower extremi- 
ties; the urine is reduced in quantity and looks like beef washings ow- 
ing to the presence of blood in the urine. 

In one form of chronic Bright's disease, increasing general debility, 
pallor of the countenance, a puffy, doughy face, and frequent passing 
of water call attention to the disease. 

In another type of Bright's disease, disturbances of digestion and 
vision ; decline of body-weight ; the skin becoming hard and dry, and of 
a yellow-white color; nosebleed, headache, thirst, and frequent passing 
of water, indicate a disease of the kidneys, occurring commonly about 
middle life. 



202 WARNINGS OF DISEASE. 

Dropsy. — The dropsy of heart disease begins about the ankles and 
feet and extends upward. 

Dropsy due to kidney trouble begins in the face with puffiness of 
the lower eyelids, and extends downwards. 

Dropsy due to liver trouble, or obstruction of circulation of blood in 
the liver region, begins in the abdomen. 

Fluctuation. — This is an indication of the presence of pus in a 
swelling. It is produced by pressing on opposite sides or parts of the 
swelling with two or more fingers of each hand. If pus is present, 
there will be felt a flowing or fluctuating motion of pus under the 
touch. 

Flatulency is a system of disordered stomach of a chronic character, 
as dyspepsia. Pain after eating is also a sign of indigestion or dis- 
ordered stomach, but there is. generally inflammation accompanying it. 

The odor of the breath enables us in many instances to determine 
the presence of disease; and certain poisons impart a peculiar odor to 
the breath. A sour breath indicates disturbances of digestion. A 
sweetish breath is found in the later stages of diabetes. The odor of 
ammonia is frequently noticed in serious kidney disturbances, and in 
all fevers the breath has the characteristic feverish odor. In tonsilitis 
and in diseases of the mouth the breath is quite foul. 

Phosphorus poisoning imparts to the breath the odor of garlic. 
Carbolic acid poisoning — if the poison has been administered by the 
mouth — imparts its well-known characteristic odor to the breath. 

The odors of alcohol and tobacco on the breath are well known. 

Seat of Pain. — The location of pain is often a guiding sign of the 
disease, though not infallible. For not infrequently the pain is felt in 
a region remote from that affected. Pain in the ear, for instance, may 
be caused by throat trouble, or an affection of the brain, quite as often 
as by a disease of the ear itself. The eye is often affected by nervous 
and brain troubles. It also swells and becomes puffed from dropsy, 
dependent upon kidney disease. The swelling of the ankles is often an 
indication of heart affections. Still there is no mistaking many of the 
diseases accompanied by pain when they are of a local nature. 

Headache plays an important part in diagnosis for it is symptom- 
atic of many diseases. 

Pain in the angle of the jaw indicates tonsilitis. Higher up, at the 
hinge near the temple, when accompanied by swelling, it leads one to 
suggest mumps. 



SYMPTOMS OF COMMON DISEASES. 203 

Soreness and difficulty in swallowing indicate throat affections. 

Pain around the heart may be caused by heart disease, neuralgia, 
pleurisy, or abscess in that region. 

The pain of neuralgia is sharp, stabbing, and comes in paroxysms. 
There is usually great tenderness felt all along the path of the nerve 
affected. 

Neuralgic pains in the joints and muscles are symptoms of influ- 
enza. 

Pain and tenderness over the stomach suggest gastric affections; 
over the bowels, increasing with pressure, indicate peritonitis, 

Pains in the joints and limbs, increasing on motion and pressure, 
are signs of rheumatic diseases. 



SOME COMMON DISEASES AND THEIR SYMPTOMS. 

It is necessary for every mother, at least, to recognize some of the 
symptoms of the common diseases. It is not expected that the layman 
will be able each time to diagnose every disease correctly, but we all 
know that our mothers had a way of telling measles from whooping 
cough and biliousness from diphtheria. Mothers of large families often 
have an extensive experience in hospital work at home, and keen, observ- 
ing, intelligent mothers often prove of valuable assistance to physicians 
by being able to early diagnose disease or locate cause of functional 
disturbances. We shall attempt in this article to give only a few of the 
common, early symptoms of the most common diseases. Their treat- 
ment will be left for another section. 

Fevers. — A fever is the most general disease of the human race. It 
attacks all ages, sexes, and constitutions. Fevers may be divided into 
three classes, viz., continual, remitting, and intermitting. A continual 
fever is that which never leaves the patient during the whole course 
of the disease. Fever is called acute when its progress is quick and 
symptoms are violent ; but, when these are more gentle, it is called slow. 
A remitting fever differs from a continual only in degree; it has fre- 
quent increases and decreases, but never wholly leaves the patient dur- 
ing the course of the disease. Intermitting fevers (agues) are those 
which, during the time the patient may be said to be ill, have evident 
intervals and abatements of the various symptoms. 

Typhoid. — The early symptoms of typhoid are usually headache, 



204 WARNINGS OF DISEASE. 

with general aching of the whole body, frequently chills and fever, 
accompanied by nervousness, even in people who appear to have no 
nerves. Often there will be slight hemorrhages from the nose or these 
may be copious and frequent. There is a loss of appetite with a desire 
to drink large quantities of water, the bowels move frequently and be- 
come tender to the touch, the tongue coated, and the eyes shiny. When 
such symptoms appear a physician should be consulted at once. It is 
sometimes difficult from clinical diagnosis to determine whether the 
case is typhoid or not, but the physician's test of the blood will usually 
prove the suspicion. 

Pneumonia. — In case of sudden colds, attended by chills and followed 
by high temperature with flushed cheeks, pain in the chest, and a general 
tired feeling, watch out for pneumonia. Grip sometimes exhibits 
something of the same symptoms, and it, too, with its multitude of 
after complications, needs careful attention. 

Measles are usually epidemic, and when in the vicinity one is on the 
lookout for symptoms to appear. Adults rarely have measles; if they 
have been fortunate enough to escape them in childhood or adolescence 
they are not likely to have them. However, escaping them in early 
life by no means makes one entirely immune, and when one is afflicted 
with this child's disease after reaching manhood or womanhood it is no 
simple matter. The early symptoms are like those of a sudden cold 
with headache and weariness. The eyes become red and the conjunc- 
tiva becomes blotched and inflamed. Usually a rash appears early, 
appearing first in the hollow of the arm, about the elbow, and around 
the waist. 

It is sometimes difficult to tell the rash of measles from the rash of 
other diseases. Roseola in children much resembles measles to the 
inexperienced. This rash comes from indigestion or from fruit poison- 
ing. The germs of measles form in crescent shaped colonies, which 
are clearly discernible when the rash first appears. Later when the 
features become swollen and the disease is at the height of its intensity, 
it is hard to decide whether it is measles, scarlet fever, or smallpox. 

Scarlet Fever or canker rash is much like measles in form, and the 
early symptoms are very similar. Usually the temperature runs higher 
and the throat and mouth show patches of canker. Scarlet fever is a 
more serious disease, however, being almost sure to be followed by 
some complication and being more severe in its intensity. Among the 
complications we find bladder and kidney troubles, abscesses of the ear 



DIPHTHERIA. 



205 



which may destroy the hearing, inflammation of the eyes causing de- 
fective vision or blindness, and many others. This disease needs most 
careful nursing, skillful attention, and a closely watched convalescence. 

Tonsilitis is a common disease in cold, damp climates, and is not 
given sufficient attention by most people. It is considered highly trans- 
missible and every precaution should be taken to guard against infect- 
ing other members of the family. Towels, napkins, glasses, spoons, 
forks, etc., should be thoroughly scalded after being used by the patient, 
and care taken not to get the breath, which is of a foul nature. The 
early symptoms of tonsilitis are not readily recognized by people in 
general, especially in small children. There is a general expression 
of lassitude and a desire to sleep. The flesh is dry and hot, the face 
flushed and a tendency to peevishness. The eyes show dark rings and 
there is a general look of illness. Upon examination of the throat the 
condition is found to be dark red in color with perhaps a few white 
patches. This condition increases, the pulse becomes full and decided 
as the poison is absorbed. 

Diphtheria is one of the most dreaded diseases and comes from a 
specific germ finding lodgment in a throat of delicate condition, fit field 
for its cultivation. The early symptoms are very like tonsilitis with 
an early appearance of the diphtheritic membrane on the tonsils and in 
the throat. Whenever diphtheria is even suspected, isolate the suspect 
till a physician has been consulted. This disease is too virulent in 
character to take any chances in spreading infection. In all cases where 
frequent sore throats are noticed in the family, careful inspection and 
disinfection should be made of the drains, closets, lavatories, cellars, 
cisterns, wells, cesspools, outhouses, or any place where disease germs 
are likely to be thriving. Do not wait till some member of the family 
is striken down with diphtheria or typhoid before these places are looked 
after. Take them in time. (See modes of disinfecting. Page 154O 

Jaundice is caused by a disarrangement of the liver or bile ducts, 
causing the skin to try to do their work by disposing of the bile through 
the pores, thus giving to the patient a yellow or lemon color. 

Appendicitis is an acute inflammation of the appendix, which is situ- 
ated below the liver in the right side of the abdomen, about 2]/ 2 inches 
below the short ribs. The pain is a griping, coiling, incisive one, 
which usually makes the patient writhe in intense agony. 



206 WARNINGS OF DISEASE. 

LIST OF SYMPTOMS 
ARRANGED FOR READY REFERENCE. 

Abdomen, Distended. — Chronic Catarrh of the Stomach. Chronic Dys- 
pepsia. Drunkard's Dyspepsia. Chronic Alcoholism. 

Abdomen, Distended and painful under pressure. — Poisoning by an irri- 
tating mineral acid. 

Abdomen, Feeling of soreness and weight on the right side above the 
hip bone. — Appendicitis. 

Abdomen, Hard and tense, — Colic or Gripes. 

Abdomen, Hard and somewhat distended. — Intestinal Colic. 

Abdomen, Pain in the. — Gallstones. Lead or Phosphorus Poisoning. 

Abdomen, Burning and tearing pain in the. — Cholera Morbus. 

Abdomen, Tense, hard, bloated, and severe cutting and boring pain in 
the. — Peritonitis. 

Abdomen, Purled out or drawn in. — Stomach Ache or Neuralgia of the 
Stomach. Gastralgia. 

Abdomen, Sunken. — Cholera Infantum. Summer Diarrhoea. 

Abdomen, Considerably swollen. — Dropsy. 

Abdomen, Swollen and gives out a hollow sound when struck. — Perito- 
nitis. Inflammation of the Bowels. 

Abdomen, Tender. — Typhoid Fever. 

Appetite, Capricious. — Dyspepsia. Indigestion, Heartburn. Diabetes 
Mellitus. 

Appetite, Loss of. — Dysentery. Bronchitis. Pneumonia. Catarrh of 
the Stomach. Acute Indigestion. Ulcerated Stomach. Inflamma- 
tion of the Stomach. Peritonitis. Jaundice. Congestion of the 
Liver. Biliousness. Catarrh of the Bladder. Inflammatory Rheu- 
matism. Rheumatic Fever. Worms. Scarlet Fever. Influenza. 

Belching. — Dyspepsia. Indigestion. Heartburn. 

Blood Vessels, Hard, tortuous and sometimes bony. — Arterio-Sclerosis. 

Blood Vessels, Stand out on face and forehead while coughing. — 
Whooping Cough. 

Bowels, Desire to evacuate constantly. — Dysentery 

Bowels, Desire to move but usually constipated. — Colic or Gripes. 

Bowels, Irregularity of. — Dysentery. 

Bowels, Gas in the. — Intestinal Indigestion. Colic. 

Bram, Rupture of vessels. — Arterio-Sclerosis. 



SYMPTOMS OF DISEASES. 207 

Breath, Bad. — Chronic Bronchitis. Acute Indigestion. Acute Catarrh 
of the Stomach. Scurvy in Children. Enlargement of the Tonsils. 
Intestinal Indigestion. Catarrh of the Head and Throat. 

Breathing, Difficult. — Hay Fever or Hay Asthma. Heart Disease, Endo- 
carditis. Dropsy. Chronic Bright's Disease. Poisoning by Am- 
monia. Poisoning by Iodine. 

Breathing, Difficult and wheezing. — Asthma. 

Breathing, Difficult and noisy. — Spasmodic Croup. Diphtheria. 

Breathing, Difficult while coughing. — Whooping Cough. 

Breathing, Irregular and rapid. — Hysteria. Malnutrition of Infants. 
Cholera Infantum or Summer Piarrhcea. Poisoning by Tainted 
Food. 

Breathing, Irregular and slow. — Apoplexy or Hemorrhage of the 
Brain. Cerebro-Spinal Meningitis. Spotted Fever. 

Breathing, Through the mouth. — Adenoid Growths. Tonsilitis. 
Quinsy. Enlargement of the Tonsils. 

Breathing, Rapid. — Pneumonia. Neuralgia of the Heart or Angina 
Pectoris. Heat Stroke or Sunstroke. Acute Bronchitis. 

Breathing, Rapid and shallow. — Pneumonia. Pleurisy. Peritonitis, 
or Inflammation of the Bowels. 

Breathing, Slow and shallow. — Acute Inflammation of the Stomach. 
Convulsions. 

Chest, Distress in the. — Congestion of the Lungs. 

Chest, Fixed and immovable. — Neuralgia of the Heart or Angina 
Pectoris. 

Chest, Fluid between lungs and chest-walls. — Pleurisy. 

Chest, Irritation in the. — Asthma. 

Chest, Lower part sunken in. — Pneumonia. 

Chest, Movements decreased over affected parts. — Pleurisy. 

Chest, Pain in the. — Bronchitis. 

Chest, Sharp pain in one spot. — Pleurisy. 

Chest, Crackling or squeaking sounds in the. — Pleurisy. 

Chest, Crackling sounds in the, which cough does not change. — Pleurisy. 

Chest, Dull sounds in the, which changes with the position. — Pleurisy. 

Chest, Moist and bubbling sounds in the. — Acute Bronchitis. 

Chest, Slight crackling or rattling sound in the. — Pneumonia. 

Chest, Small and great bubbling sounds in the. — Pneumonia. 

Chest. Rattling sound in the. — Bronchitis. Pneumonia. 

Chest, Rough, rasping sound in the. — Membranous Croup. 



208 WARNINGS OF DISEASE. 

Chest, Soreness in the. — Bronchitis. 

Chest, Tenderness on pressure. — Pleurisy. 

Chill. — Erysipelas. Malarial Fever. Consumption. Pleurisy. Inflam- 
mation of the Bowels. Cholera Morbus. Appendicitis. Tonsil- 
itis. Quinsy. Scarlet Fever. Diphtheria. Influenza or La Grippe. 

Chill, Followed by fever. — Typhoid Fever. Inflammatory Rheumatism. 
Rheumatic Fever. Peritonitis or Inflammation of the Bowels. 

Chill, Slight. — Inflammation of the Bowels. Cholera Morbus. 

Chill, Violent. — Smallpox. Pneumonia. 

Circulation of the Blood, Poor. — Inanition of Infants. Malnutrition 
of Infants. Intestinal Indigestion. 

Cold, Bad.— Measles. 

Cold, Moderate. — Whooping Cough. 

Cold in Nose and Head. — Acute Bronchitis. 

Cold in Nose and Throat. — Acute Bronchitis. 

Colic. — Poisoning with Sewer Gas. Cholera Morbus. Gallstones. 
Improper Feeding of Infants. Intestinal Colic. Chronic Con- 
stipation. Worms. Lead Poisoning. Copper Poisoning. Tainted 
Food Poisoning. 

Colic, During digestion of food. — Peritonitis or Inflammation of the 
Bowels. 

Colic. — Gallstones. Biliary Calculi. 

Constipation. — Acute Bronchitis. Chronic Catarrh of the Stomach. 
Chronic Dyspepsia. Drunkard's Dyspepsia. Chronic Alcoholism. 
Dyspepsia. Indigestion. Heartburn. Colic or Gripes. Habit- 
ual or Chronic Constipation. Dropsy. Congestion of the Liver 
or Biliousness. Inflammatory Rheumatism. Rheumatic Fever. 
Diabetes Mellitus. Diabetes Insipidus. Rickets. Intestinal 
Indigestion. Appendicitis. Cerebro-Spinal Meningitis. 

Convulsions. — Tumors of the Brain. Epilepsy. Cerebro-Spinal Men- 
ingitis. Whooping Cough. Poisoning. 

Convulsions, Slight twitching. — Convulsions. 

Convulsions, Violent. — Strychnine Poisoning. 

Cough. — Hay Fever or Hay Asthma. Congestion of the Lungs. 
Pneumonia. Inflammation of the Throat. Typhoid Fever, 
Poisoning by Ammonia. Acute Pharyngitis. Acute Laryngitis. 

Cough, Dry and hard. — Bronchitis. 

Cough, Explosive. — Whooping Cough. 

Cough, Hacking. — Congestion of the Lungs. Pleurisy. Consumption. 



SYMPTOMS OF DISEASES. 209 

Cough, Hoarse and croupy. — Congestion of the Lungs. Spasmodic 
Croup. Membranous Croup. 

Cough, Paroxysmal. — "Whooping Cough. 

Cough, Short. — Heart Disease. Endocarditis. 

Cough, Tight. — Acute and Chronic Bronchitis. 

Cough, with rust-colored expectoration. — Pneumonia. 

Cramps in the Muscles. — Muscular Rheumatism. 

Cramps in Thighs, Calves, Fingers, and Toes. — Cholera Morbus. 

Cry, Low, distressed moan. — Cerebro- Spinal Meningitis. 

Cry, Sharp and piercing. — Colic in Infants. 

Cry, Single, peculiar. — Epilepsy. 

Deafness. — Apoplexy. Congestion of the Brain. Typhoid Fever. 

Deafness, Defect in hearing. — Tumors of the Brain. 

Delirium. — Smallpox. Pneumonia. Diphtheria. Lead and Copper 
Poisoning, Tainted Meat Poisoning. 

Delirium, with snakes, horrors, etc. — Delirium Tremens. Alcoholism. 
Erysipelas. 

Delirium, with throwing hands and arms about the head. — Cerebro- 
spinal Meningitis. Typhoid Fever. Influenza or La Grippe. 

Depression. — Neuralgia of the Heart or Angina Pectoris. Acute 
Gastritis. Chronic Catarrh of the Stomach. Chronic Dyspepsia. 
Drunkard's Dyspepsia. Cystitis. Catarrh of the Bladder. Scurvy. 
Typhoid Fever. 

Depression, Easily emotional and whimsical. — Hysteria. 

Diarrhoea. — Erysipelas. Inflammation of the Bowels. Tonsilitis. 
Quinsy. Diarrhoea. Cholera Morbus. Summer Diarrhoea. 
Scarlet Fever. Typhoid Fever. Copper Poisoning. Mercury 
Poisoning. Poisonous Mushrooms. Tainted Food. 

Diarrhoea, with purging. — Acute Inflammation of the Stomach or 
Gastritis. Inflammation of the Bowels. 

Diarrhoea, Moderate. — Dysentery or Bloody Flux. Pneumonia. Jaun- 
dice. Acute Bright's Disease. Inanition in Infants. Inflam- 
mation of the Mouth in Infants. 

Diarrhoea, Severe. — Dysentery or Bloody Flux. 

Digestion, Disturbance of. — Erysipelas. Asthma. Pneumonia. Con- 
sumption. Chronic Catarrh of the Stomach. Chronic Dyspepsia. 
Drunkard's Dyspepsia. Alcoholism. Ulcer of the Stomach. 
Locomotor Ataxia. Tabes Dorsalis. Consumption of the Spinal 
Cord. Imperfect Nutrition of Infants. 



210 WARNINGS OF DISEASE. 

Digestion, Indigestion. — Cancer of the Stomach. Dyspepsia. Indi- 
gestion. Heartburn. Hysteria. Typhoid Fever. 

Dizziness, with faintness. — Stomach Ache. Gastralgia. Neuralgia of 
the Stomach. Congestion of the Brain. Apoplexy. Hemorrhage 
of the Brain. Tumors of the Brain. Hysteria. Nervous Pros- 
tration or Neurasthenia. Chronic Bright's Disease. Typhoid 
Fever. Poisoning by Carbolic Acid, by Copper, by Arsenic, by 
Illuminating Gas, by Coal Stove Gas, and by Belladonna. . 

Dropsy. — Dropsy. Acute Bright's Disease. Chronic Bright's Disease. 

Drowsiness. — Dyspepsia. Indigestion. Heartburn. Measles. Influ- 
enza or La Grippe. Poisoning by Morphine, Opium, etc. 

Ears, Pain in. — Earache. 

Ears, Inflammation in. — Scarlet Fever. 

Ears, Noises in the. — Congestion of the Brain. Delirium Tremens. 
Poisoning from Phosphorus. 

Ears, Running from the. — Measles. 

Eruptions, Blisters form on pimples and pus in blisters about the eighth 
day. — Smallpox. 

Eruptions, Bright scarlet, tiny points; passing finger over rash leaves 
white line. — Scarlet Fever. 

Eruptions, Coarse red spots appearing on the third day first on fore- 
head and lips. — Smallpox. 

Eruptions, Dark red spots appearing first on the ears and gradually 
spreading over the entire body. — Measles. 

Eruptions, Small red pimples on a restricted part of the body, running 
together, containing a thick watery fluid, then crusting over. — 
Eczema. 

Eruptions, Large irregular patches on face, from the size of a pinhead 
to that of a small pea, giving a feeling like small shot. — German 
Measles. 

Eruptions, Pimples on scalp or face which spread slowly ; become larger ; 
have little blisters in them; blisters dry and form pits or hollow 
scars. — Chicken Pox. 

Eruptions, Pus forms in pimples and fever is high. — Smallpox. 

Eruptions, Red spots which run together, spread, and follow a chill. — 
Erysipelas. 

Eruptions, Red spots form along the spine. — Cerebro-Spinal Meningitis 
or Spotted Fever. 



SYMPTOMS OF DISEASES. 211 

Eruptions, Like flea-bites upon the abdomen, chest, and back. — Typhoid 
Fever. 

Eruptions, Rose-colored on skin. — Poisoning by Iodine. 

Eruptions on Face and Neck of Infants. — Sweat Rash. 

Eruptions, Tiny bright red pimples very close together in hot weather, 
with tiny sac of watery fluid. — Prickly Heat. 

Eruptions, Tiny eruption, intolerable itching. — Poison Ivy. 

Expectoration, Bloody. — Inflammation of the Throat. Follicular 
Pharyngitis. 

Expectoration, Brownish-red and yellow. — Pneumonia. 

Expectoration, Cheesy. — Enlargement of the Tonsils. 

Expectoration, Glairy mucus. — Consumption. 

Expectoration, Rust-colored. — Pneumonia. 

Expectoration, Slightly streaked with blood. — Congestion of the Lungs. 

Expectoration, Thick, stringy, and yellowish. — Chronic Bronchitis. 

Eyes, Bloodshot. — Smallpox. Congestion of the Lungs. Congestion 
of the Brain. Heat Stroke. Sunstroke. Inflammation of the 
Eyes of Newborn Infants. Nasal Catarrh. Measles. Poison- 
ing by Iodine. Inflammation of the Conjunctiva. Pink Eye. 
Granulated Lids. 

Eyes, Fixed stare for a moment. — Convulsions. 

Eyes, Swollen lids. — Granulated Lids. Kidney Complaint. 

Eyes, Sensitive to light. — Measles. Influenza or La Grippe. 

Eyes, Pain in and around. — Pregnancy. Conjunctivitis. Granulated 
Lids. Neuralgia. Eye-strain. 

Eyes, Pupils small. — Congestion of the Brain. Poisoning by Car- 
bolic Acid, and by Morphine, Opium, etc. 

Eyes, Pupils large. — Cerebro-Spinal Meningitis or Spotted Fever. 
Poisoning by Belladonna. 

Eyes, Sunken. — Scurvy. Cholera Infantum or Summer Diarrhoea. 

Eyes, Thick, creamy discharge with swollen lids. — Conjunctivitis. 
Inflammation of the Eyes of Newborn Infants. Pink Eye. 

Eyes, Watery. — Asthma. Hay Fever or Hay Asthma. Measles. 
Influenza or La Grippe. 

Eyes, Whites turned yellow. — Jaundice. Congestion of the Liver. 
Biliousness. Poisoning by Phosphorus. 

Face, Anxious look. — Pleurisy. 

Face, Rash or eruption on. — Eczema. Measles. 

Face, Dark circles under eyes. — Scurvy. Intestinal Indigestion. 



212 WARNINGS OF DISEASE. 

Face, Dull and stupid expression. — Adenoid Growths. 

Face, Flushed and bathed in perspiration. — Asthma. 

Face, Light yellow color. — Jaundice of Newborn Infants. 

Face, Very pale. — Heat Stroke. Sunstroke. Chronic Bright's Disease. 
Scurvy. Membranous Croup. Convulsions. Epilepsy. 

Face, Pinched features and sunken eyes. — Peritonitis. 

Face, Pinched features, sunken eyes, evidence of pain. — Gallstones. 

Face, Pinched look. — Dysentery. Bloody Flux. Acute Inflammation 
of the Stomach or Gastritis. Stomach Ache. Neuralgia of the 
Stomach, or Gastralgia. Colic or Gripes. Diabetes Mellitus. 
Cholera Infantum. Colic. Peritonitis, or Inflammation of the 
Bowels. 

Face, Puffiness under the eyes. — Acute Bright's Disease. 

Face, Puffy and swollen. — Acute Bright's Disease. Scurvy. 

Face, Red and purple while coughing. — Whooping Cough. 

Face, Red. — Smallpox. Pneumonia. Congestion of the Brain. 
Apoplexy. Hemorrhage of the Brain. 

Faintness. — Stomach Ache, or Gastralgia, or Neuralgia of the Stom- 
ach. Congestion of the Brain. Apoplexy or Hemorrhage of the 
Brain. Tumors of the Brain. Hysteria. Nervous Prostration 
or Neurasthenia. Chronic Bright's Disease. Typhoid Fever. 
Poisoning by Carbolic Acid. Copper Poisoning. Arsenic Poison- 
ing. 

Feet and Legs, Swollen ankles. — Cancer of the Stomach. Dropsy. 

Feet and Legs, Cold. — Stomach Ache, Gastralgia, or Neuralgia of the 
Stomach. Nervous Prostration or Neurasthenia. Inanition of 
Infants. Imperfect Nutrition. Cholera Infantum. Intestinal 
Indigestion. Peritonitis or Inflammation of the Bowels. Scarlet 
Fever. 

Feet, Gangrene of. — Arterio-Sclerosis. 

Feet and Legs, Numbness. — Locomotor Ataxia. Paralysis. Infantile 
Paralysis. 

Feet, Legs, and Arms. Deformed. — Rickets. 

Feet and Legs, Pain and soreness in the. — Congestion of the Liver 
or Biliousness. Locomotor Ataxia. Diabetes Mellitus. 

Feet, Limbs jerk. — Congestion of the Brain. 

Fever, Slight. — Smallpox. Dysentery. Malarial Fever. Fever and 
Ague. Intermittent Fever. Bronchitis. Pneumonia. Consump- 
tion. Acute Catarrh of the Stomach. Acute Indigestion. In- 



SYMPTOMS OF DISEASES. 213 

flammation of the Bowels. Appendicitis. Peritonitis. Jaundice. 

Congestion of the Liver. Biliousness. Acute Bright' s Disease. 

Catarrh of the Bladder. Pleurisy. Measles. Chicken Pox. 

Mumps. Diphtheria. 
Fever, High. — Smallpox. Erysipelas. Malarial Fever. Intermittent 

Fever. Fever and Ague. Pneumonia. Inflammation of the 

Throat. Tonsilitis. Quinsy. Cholera Infantum. Peritonitis. 

Cerebro-Spinal Meningitis. Scarlet Fever. Measles. Typhoid 

Fever. Influenza or La Grippe. 
Fever, Secondary. — Smallpox. 
Gas in Intestines and Bowels. — Intestinal Indigestion. Colic. Worms. 

Typhoid Fever. Indigestion. 
Gums, Swollen and bleed easily. — Scurvy. Inflammation of the Mouth. 

Stomatitis. Ulcerated Sore Mouth. 
Hands, Cold. — Stomach Ache. Gastralgia. Neuralgia of the Stomach. 

Nervous Prostration or Neurasthenia. Inanition of Infants. Im- 
perfect Nutrition. Cholera Infantum. Intestinal Indigestion. 

Peritonitis. Scarlet Fever. 
Hands and Arms, Deformed. — Rickets. Rheumatism of the Joints. 
Hands, Imperfect ■ use of. — Locomotor Ataxia. Paralysis. 
Hands and Arms, Thrown about the head. — Cerebro-Spinal Meningitis. 

Spotted Fever. Typhoid Fever. 
Hard Palate covered with red spots. — Scarlet Fever. Measles. 
Head, Rush of blood to the. — Congestion of the Brain. Apoplexy. 
Headache. — Smallpox. Malarial Fever. Intermittent Fever. Fever 

and Ague. Pneumonia. Acute Catarrh of the Stomach. Acute 

Indigestion. Dyspepsia. Heartburn. Congestion of the Liver. 

Biliousness. Neuralgia. Sick Headache. Chronic Headache. 

Congestion of the Brain. Apoplexy. Nervous Prostration. 

Neurasthenia. Bright's Disease. Diabetes Insipidus. Pneumonia. 

Pleurisy. Eye-strain. Constipation. Nervousness. Rheumatism. 

Cerebro-Spinal Meningitis. Measles. Mumps. Diphtheria. 

Typhoid Fever. Influenza or La Grippe. Poisoning by Carbolic 

Acid. Poisoning by Iodine. Poisoning by Arsenic. Poisoning 

by Belladonna. Poisoning by Morphine or Opium. Poisoning by 

Tainted Food, Poisonous Mushrooms, etc. 
Headache, Constant and gradually growing worse. — Tumors of the 

Brain. 



2i 4 WARNINGS OF DISEASE. 

Heart, Disturbance of action of. — Consumption. Dropsy. Pleurisy. 

Tobacco Poisoning. 
Heart, Distress around the. — Inflammation of the Membrane of the 

Heart. Endocarditis. 
Heart, Palpitation of the. — Asthma. Dyspepsia. Indigestion. Heart- 
burn. Hysteria. Nervous Prostration or Neurasthenia. Chronic 

Bright's Disease. Scurvy. 
Heart, Severe pain in the. — Neuralgia of the Heart or Angina Pectoris. 
Heart, Weak action of the. — Poisoning by Arsenic. 
Heartburn. — Acute Catarrh of the Stomach. Acute Indigestion. 

Dyspepsia. Indigestion. Heartburn. 
Heat, Flashes of. — Acute Catarrh of the Stomach. Acute Indigestion. 
Hemorrhage from Bowels. — Hemorrhoids or Piles. Scurvy. 

Habitual Constipation. Dysentery or Bloody Flux. 
Hemorrhage from Lungs. — Consumption. Hemoptysis or Bleeding 

from the Lungs. 
Hemorrhage from the Nose. — Epistaxis or Nosebleed. Whooping 

Cough. Diphtheria. Typhoid Fever. Dry Catarrh. 
Hemorrhage from the Mouth. — Scurvy. 
Hemorrhage from the Stomach. — Scurvy. Hematemesis or Vomiting 

of Blood. 
Hemorrhage of the Uterus. — Uterine Hemorrhage. Labor. 
Hiccough. — Peritonitis. Hysteria. 

Inflammation around the Anus. — Hemorrhoids or Piles. 
Inflammation of the Bowels. — Peritonitis. 
Inflammation of the Covering of the Lungs. — Pleurisy. 
Inflammation of the Ears. — Scarlet Fever. 
Inflammation of the Mouth and Throat. — Influenza or La Grippe. 

Poisoning by Ammonia. 
Inflammation of the Tonsils. — Tonsilitis. Quinsy. 
Joints, Pain and stiffness in. — Inflammatory Rheumatism. 
Joints, Swelling around the. — Scurvy. Rickets. Cerebro-Spinal 

Meningitis. 
Kidneys and Bladder, Pain near. — Locomotor Ataxia. Acute Bright's 

Disease. Diabetes Mellitus. Spasm of the Bladder. Stone in 

the Bladder. Scarlet Fever. 
Lassitude. — Poisoning by Sewer Gas. Bad Ventilation. Malarial 

Fever. Intermittent Fever. Acute Bronchitis. Inflammation of 

the Bowels. Congestion of the Liver. Biliousness. Nervous 



• SYMPTOMS OF DISEASES. 215 

Prostration or Neurasthenia. Scurvy. Diabetes Mellitus. 
Measles. 

Lips, Blue. — Malarial Fever. Intermittent Fever. Spasmodic Croup. 
Convulsions. 

Lips, Pale. — Scurvy. Worms. 

Lips, Dry. — Eczema. Pneumonia. Influenza or La Grippe. 

Lips, Sore and cracked. — Pneumonia. Diphtheria. 

Liver, Pain in region of. — Gallstones. Congestion of the Liver. 
Biliousness. Poisoning by Phosphorus. 

Lungs, Bleeding from. — Hemoptysis. 

Lungs, Congested. — Acute Endocarditis. 

Memory, Confused. — Epilepsy. 

Memory, Poor. — Dyspepsia. Indigestion. Heartburn. Locomotor 
Ataxia. Nervous Prostration or Neurasthenia. Diabetes Insip- 
idus. 

Mind, Confused. — Epilepsy. 

Mind, Disturbed by fancies. — Poisoning by Belladonna. Delirium. 

Mind, Irritable and weak. — Nervous Prostration. 

Mouth, Bad taste in. — Acute Catarrh of the Stomach. Acute Indiges- 
tion. 

Mouth, Breathing through. — Tonsilitis. Quinsy. Adenoids. 

Mouth, Dry. — Mumps. Poisoning by Tainted Food. 

Mouth, Discharge from. — Diphtheria. 

Mouth, Inflamed. — Inflammation of the Mouth. Stomatitis. Poison- 
ing. 

Mouth, Taste of copper or metal in. — Mercury and Copper Poisoning. 

Muscles, Shrinking of. — Paralysis. 

Muscles, Flabby. — Scurvy. Rickets. Intestinal Indigestion. 

Muscles, Twitching of. — Convulsions. Epilefpsy. St. Vitus's Dance. 
Poisoning by Strychnine or by Aconite. 

Muscles, Pain in. — Muscular Rheumatism. 

Muscles, Weak. — Diphtheria. Typhoid Fever. 

Nails, Blue. — Malarial Fever. Intermittent Fever. Fever and Ague. 

Nausea, Slight. — Dysentery or Bloody Flux. Malarial Fever. Inter- 
mittent Fever. Fever and Ague. Inflammation of the Bowels. 
Peritonitis. Jaundice. Congestion of the Liver. Biliousness. 
Tumors of the Brain. Bright's Disease. Typhoid Fever. 

Nausea, Severe. — Acute Catarrh of the Stomach. Acute Gastritis. 
Inflammation of the Stomach. 



216 WARNINGS OF DISEASE. 

Nervousness. — Hysteria. Nervous Prostration. Neurasthenia. Dia- 
betes Mellitus. Intestinal Indigestion. Typhoid Fever. 

Night Sweats. — Consumption. Typhoid Fever. 

Nose, Discharge from the. — Asthma. Hay Fever or May Asthma. 
Abscess in the Throat. Adenoid Growths. Nasal Catarrh. Spas- 
modic Croup. Measles. Diphtheria. Influenza or La Grippe. 

Nosebleed. — Erysipelas. Pneumonia. Whooping Cough. Diphtheria. 
Typhoid Fever. Epistaxis. Dry Catarrh. 

Nose, Talking through the. — Adenoid Growths. 

Nose, Stoppage in the. — Nasal Catarrh. 

Numbness. — Hysteria. Poisoning by Copper. 

Numbness of the Feet. — Locomotor Ataxia. 

Numbness of Finger Tips. — Poisoning by Oxalic Acid. 

Odor to Breath. — Acute Catarrh of the Stomach. Acute Indigestion. 
Cancer of the Stomach, Scurvy, Indigestion in the Intestines. 

Odor to Stools, Disagreeable. — Cholera Infantum. Summer Diarrhoea. 
Indigestion in the Intestines. Typhoid Fever. 

Odor to Urine, Sweetish. — Diabetes Mellitus. 

Odor, Peculiar about sick person. — Smallpox. 

Pain in the Bladder. — Catarrh of the Bladder. 

Pain in the Joints. — Rheumatism. 

Pain in the Course of the Nerves. — Neuralgia. 

Pain in the Rectum with Burning. — Dysentery. Piles or Hemorrhoids. 

Pain in the Pit of the Stomach. — Chronic Catarrh of the Stomach. 
Chronic Dyspepsia. Drunkard's Dyspepsia. 

Pain, Cutting, tearing, twisting, and pinching, over the abdomen. — 
Colic or Gripes. 

Pain, Colicky. — Dysentery. Stomach Ache or Gastralgia. Colic or 
Gripes. 

Pain, Dull, in back and over kidneys. — Acute Bri^ht's Disease. 

Pain in the Abdomen. — Smallpox. Jaundice. Peritonitis or Inflam- 
mation of the Bowels. Lead Poisoning. Phosphorus Poisoning. 
Poisonous Food. 

Pain in the Back. — Smallpox. Ulcer of the Stomach. Diabetes Mellitus. 
Inflammation of the Tonsils. Quinsy. Cerebro-Spinal Menin- 
gitis. Spotted Fever. Measles. Mumps. 

Pain in the Bowels. — Dysentery. 

Pain in the entire Body. — Acute Bronchitis. Pneumonia. Influenza. 

Pain in the Chest. — Acute Bronchitis. 



SYMPTOMS OF DISEASES. 217 

Pain in the Ears. — Earache. Scarlet Fever. 

Pain in and about the Eyes. — Hyeropia. Far-sightedness. 

Pain in the Limbs. — Locomotor Ataxia. 

Pain in the Heart, Intense, sickening. — Neuralgia of the Heart or 
Angina Pectoris. 

Pain in the Lungs. — Pleurisy. 

Pain in the Muscles. — Inflammation of the Tonsils. Quinsy. Muscu- 
lar Rheumatism. 

Pain in the Side. — Pleurisy. Appendicitis. 

Pain, Sudden. Piercing in the region of the liver. — Gallstones. 

Pain upon Swallowing. — Diseases of the Upper Part of the Throat. 

Paralysis. — Infantile Paralysis. Apoplexy. Hemorrhage of the Brain. 
Locomotor Ataxia. Tabes Dorsalis. Consumption of the Spinal 
Cord. Copper, Blue Vitriol, Verdigris Poisoning. 

Paralysis of the Vocal Cords. — Tumors of the Brain. 

Paralysis, Sudden, of any part of the body. — Hysteria. 

Paralysis, Sensations blunted. — Infantile Paralysis. 

Perspiration, Clammy. — Cholera Morbus. 

Perspiration, Gentle, soft. — Gastralgia. Stomach Ache. 

Perspiration on Head. — Rickets. 

Perspiration, Profuse at night. — Typhoid Fever. 

Pits. — Smallpox. 

Pot-belly. — Rickets. 

Prostration, Marked. — Lobar Pneumonia. Tuberculosis. Consumption. 
Heat Stroke. Sunstroke. 

Pulse, Strong and rapid. — Smallpox. Acute Bronchitis. Malarial 
Fever. Intermittent Fever. Fever and Ague. Swamp Fever. 
Congestion of the Lungs. Lobar Pneumonia. Acute Bright's 
Disease. Membranous Croup. Pneumonia. Lung" Fever. 

Pulse, Weak and rapid. — Dysentery. Bloody Flux. Broncho-Pneu- 
monia. Acute Gastritis. Heat Stroke. Sunstroke. Cholera In- 
fantum. Summer Diarrhoea. Peritonitis. Inflammation of the 
Bowels. Scarlet Fever. Diphtheria. Influenza or La Grippe. 
Sulphuric Acid Poisoning. Hydrochloric Acid or Nitric Acid 
Poisoning. Saltpeter Poisoning. Phosphorus Poisoning. Strych- 
nine, Morphine, and Opium Poisoning. 

Pulse, Slow. — Apoplexy. Nicotine (Tobacco) Poisoning. 

Pulse, Hard and tense. — Arterio-Sclerosis. Colic. Gripes. Perito- 
nitis. 



218 WARNINGS OF DISEASE. 

Pulse, Irregular. — Arterio-Sclerosis. Gastralgia. Stomach Ache. 

Purging. — Cholera Morbus. 

Restlessness. — Erysipelas. St. Anthony's Fire. Rickets. Peritonitis. 

Inflammation of the Bowels. 
Restlessness, at night. — Rickets. Cerebro-Spinal Meningitis. Spotted 

Fever. 
Restlessness and Fretfulness. — Cholera Infantum. Summer Diarrhoea. 

Indigestion in the Intestines. Peritonitis. Inflammation of the 

Bowels. 
Scabs and Crusts. — Smallpox. Eczema. Seborrhea. Prickly Heat. 

Chicken Pox. 
Sight, Interfered with. — Locomotor Ataxia. Tabes Dorsalis. Con- 
sumption of the Spinal Cord. Congestion of the Brain. Tumors 

of the Brain. Delirium Tremens. Heat Stroke. Sunstroke. 

Chronic Bright's Disease. Influenza or La Grippe. Nicotine 

(Tobacco) Poisoning. 
Sight, Flashes of light. — Congestion of the Brain. 
Sight, Floating spots before the eyes. — Illuminating Gas Poisoning. 
Skin, Blue. — Iodine Poisoning. Arsenic Poisoning. Illuminating Gas 

and Coal Stove Gas Poisoning. 
Skin, Cold and clammy. — Acute Gastritis. Colic. Gripes. Cholera 

Morbus. Heat Stroke. Sunstroke. Diseases dependent upon 

Food and Feeding. Cholera Infantum. Summer Diarrhoea. 

Membranous Croup. 
Skin, Cold. — Colic. Gripes. Peritonitis. Gallstones. Heat Stroke. 

Sunstroke. Saltpeter Poisoning. 
Skin, Cool and rough. — Dysentery. Bloody Flux. 
Skin, Covered with rash. — Scarlet Fever. Measles. Chicken Pox. 

Belladonna (Atropine — Nightshade) Poisoning. Tainted Meat 

Poisoning. Fish, Mussels, Cheese, and Milk Poisoning. 
Skin, Dry, harsh, and itchy. — Jaundice. Measles. 
Skin, Goose-flesh appearance. — Malarial Fever. Intermittent Fever. 

Fever and Ague. Swamp Fever. 
Skin, Hot and dry. — Acute Bronchitis. Sunstroke. Acute Bright's 

Disease. Diabetes Insipidus. Pneumonia. Lung Fever. 
Skin, Irregular about blood vessels. — Arterio-Sclerosis. 
Skin, Muddy color. — Congestion of the Liver. Biliousness. Scurvy. 

Indigestion in the Intestines. 
Skin, Pale. — Malarial Fever. Intermittent Fever. Fever and Ague. 



SYMPTOMS OF DISEASES. 219 

Swamp Fever. Tuberculosis. Consumption. Cancer of the Stom- 
ach. Diseases dependent upon Food and Feeding. Scurvy. 
Chronic Enlargement of the Tonsils. Cholera Infantum. Sum- 
mer Diarrhoea. Indigestion in the Intestines. Typhoid Fever. 

Skin, Red, irritated and swollen. — Poison Ivy. 

Skin, Scales off. — Erysipelas. St. Anthony's Fire. Measles. 

Skin, Sensitive. — Neuralgia. 

Skin, Yellow color. — Jaundice in Diseases of the Newborn Child. 

Sleeplessness. — Smallpox. Erysipelas. St. Anthony's Fire. Lobar 
Pneumonia. Chronic Catarrh of the Stomach. Chronic Dyspep- 
sia. Drunkard's Dyspepsia. Dyspepsia. Indigestion. Heart- 
burn. Delirium Tremens. Alcoholism. Nervous Prostration. 
Cystitis. Catarrh of the Bladder. Imperfect Nutrition. Difficult 
Teething. Indigestion in the Intestines. Colic. 

Sleeplessness. — Typhoid Fever. Nicotine (Tobacco) Poisoning. 

Sneezing. — Hay Fever. Nasal Catarrh. Measles. 

Snoring. — Chronic Enlargement of the Tonsils. 

Stomach, Bleeding from. — Hematemesis. Vomiting of Blood. 

Stomach, Bloated. — Gastralgia. Stomach Ache. Acute Indigestion in 
the Stomach. 

Stomach, Burning- feeling in the. — Acute Gastritis. Ulcer of the 
Stomach. 

Stomach, Distress in and about the. — Erysipelas. St. Anthony's Fire. 
Acute Catarrh of the Stomach. Acute Indigestion. Ulcer of the 
Stomach. Cancer of the Stomach. Dyspepsia. Indigestion. 
Heartburn. Cholera Morbus. Jaundice. Acute Indigestion in 
the Stomach. Phosphorus Poisoning. Arsenic Poisoning. 
Tainted Sausages Poisoning. 

Stomach, Gas in. — Acute Catarrh of the Stomach. Acute Indigestion. 
Dyspepsia. Indigestion. Heartburn. 

Stomach, Heaviness. — Acute Catarrh of the Stomach. Acute Indiges- 
tion. Cancer of the Stomach. Acute Indigestion in the Stomach. 

Stomach, Sour. — Cancer of the Stomach. 

Stools, Bloody. — Dysentery. Bloody Flux. Hemorrhoids. Piles. 
Chronic Constipation. Copper, Blue Vitrol, Verdigris Poisoning. 

Stools, Dry. — Diabetes Mellitus. 

Stools, Disagreeable odor. — Cholera Infantum. Summer Diarrhoea. 
Indigestion in the Intestines. Typhoid Fever. 

Stools, Frequent. — Cholera Infantum. Summer Diarrhoea. Typhoid 
Fever. 



220 WARNINGS OF DISEASE. 

Stools, Pale. — Diabetes Mellitus. Indigestion in the Intestines. 

Stools, Undigested food in. — Acute Indigestion in the Stomach. 

Stools, Watery. — Inflammation of the Bowels. Cholera Morbus. 
Cholera Infantum. Summer Diarrhoea. 

Swallowing, Difficulty in. — Thrush. Diseases of the Upper Part of the 
Throat. Inflammation of Tonsils. Quinsy. Measles. 

Swelling of Ankles, Legs, or Abdomen. — Tuberculosis. Consumption. 
Gastralgia. Stomach Ache. Dropsy. Acute Bright' s Disease. 

Swelling of the Eyelids. — Trachoma. Granulated Lids. 

Swelling of the Face. — Smallpox. Acute Bright's Disease. Mumps. 

Swelling of the Jaw. — Mumps. 

Swelling of the Joints. — Appendicitis. Muscular Rheumatism. Scurvy. 
Cerebro-Spinal [Meningitis. Spotted Fever. 

Swelling of the Skin. — Erysipelas. St. Anthony's Fire. Poison Ivy. 

Teeth become loose. — Scurvy. 

Teeth. Chatter. — Malarial Fever. Intermittent Fever. Fever and 
Ague. Swamp Fever. 

Teeth, Grind. — Indigestion in the Intestines. Round Worm. 

Thirst, Intense. — Chronic Catarrh of the Stomach. Chronic Dyspepsia. 
Drunkard's Dyspepsia. Cholera Morbus. Inflammatory Rheu- 
matism. Acute Articular Rheumatism. Diabetes Mellitus. 
Cholera Infantum. Summer Diarrhoea. Belladonna (Atropine — 
Xightshade) Poisoning. Malarial Fever. Swamp Fever. Fever 
and Ague. 

Thirst, Moderate. — Acute Bronchitis. 

Throat, Dryness of the. — Acute Gastritis. Diseases of the Tapper Part 
of the Throat. Belladonna (Atropine — Xightshade) Poisoning. 

Throat, Deposit in the. — Diphtheria. Chronic Catarrh of the Throat. 
Chronic Pharyngitis. 

Throat, Foreign bodies in the. — Foreign Bodies in the Air Passages. 

Throat, Feeling, as of ball in. — Hysteria. 

Throat, Hoarseness. — Acute Laryngitis. Chronic Laryngitis. 

Throat, Inflamed. — Scarlet Fever. Diphtheria. Influenza or La 
Grippe. Sulphuric Acid and Mercury. Corrosive Sublimate Poison- 
ing. Acute Catarrh of the Throat. Acute Pharyngitis. Chronic 
Catarrh of Throat. Chronic Pharyngitis. 

Throat, Raw. — Chronic Catarrh of the Throat. Chronic Pharyngitis. 

Throat, Rattling in the. — Epilepsy. 

Throat, Spasms in the. — Membranous Croup. 



SYMPTOMS OF DISEASES. 221 

Throat, Sore. — Scarlet Fever. Measles. Diphtheria. Iodine Poison- 
ing. Acute Catarrh of the Throat. Acute Pharyngitis. 

Throat, Tonsils swollen. — Diseases of the Upper Part of the Throat. 
Inflammation of the Tonsils. Quinsy. 

Throat, White and looks burned. — Carbolic Acid Poisoning. 

Tongue, Coated. — Erysipelas. St. Anthony's Fire. Dysentery. 
Bloody Flux. Acute Catarrh of th Stomach. Acute Indigestion. 
Jaundice. Congestion of the Liver. Biliousness. Inflammation 
of the Mouth. Thrush. Acute Indigestion in the Stomach. 
Cholera Infantum. Summer Diarrhoea. Indigestion in the Intes- 
tines. Cerebro-Spinal Meningitis. Spotted Fever. Typhoid 
Fever. Influenza or La Grippe. 

Tongue covered with small white spots. — Thrush. 

Tongue, Dry. — Diphtheria. 

Tongue, Edges red. — Inflammation of the Mouth. 

Tongue, Swollen. — Inflammation of the Mouth. 

Tumors in Abdomen on Right Side over Hip. — Appendicitis. 

Tumors of Brain. — Delirium Tremens. Alcoholism. 

Tumors, Protruding from Anus. — Hemorrhoids. Piles. 

Ulcers. — Inflammation of the Mouth. 

Ulcers in Stomach. — Ulcers of the Stomach. 

Unconsciousness. — Heat Stroke. Sunstroke. Convulsions. Illumin- 
ating Gas. Coal Stove Gas Poisoning. 

Urine, Blood in the. — Hematuria. Blood in the Urine. Poisonous 
Mushrooms. 

Urine, Frequent desire. — Acute Bright's Disease. Cystitis. Catarrh 
of the Bladder. Diabetes Mellitus. Diabetes Insipidus. 

Urine, Heavy and dark color. — Jaundice. Acute Bright's Disease. 
Cystitis. Catarrh of the Bladder. Carbolic Acid Poisoning. 

Urine, Lack of control of. — Enuresis. Bed Wetting. 

Urine, Large amount of. — Diabetes Mellitus. Diabetes Insipidus. 

Urine, Pale and watery. — Diabetes Mellitus. Diabetes Insipidus. 

Urine, Scanty. — Malarial Fever. Intermittent Fever. Fever and Ague. 
Swamp Fever. Acute Catarrh of the Stomach. Acute Indiges- 
tion. Dropsy. 

Urine, Scanty and highly colored. — Dysentery. Bloody Flux. Lobar 
Pneumonia. Broncho-Pneumonia. Chronic Catarrh of the 
Stomach. Chronic Dyspepsia. Drunkard's Dyspepsia. Dyspep- 
sia. Indigestion. Heartburn. Congestion of the Liver. Bilious- 



'222 WARNINGS OF DISEASE. 

ness. Acute Bright's Disease. Chronic Bright'' s Disease. In- 
flammatory Rheumatism. Acute Articular Rheumatism. Scurvy. 
Pneumonia. Lung Fever. 

Veins, Stand out clearly. — Acute Endocarditis. 

Voice, Affected. — Heat Stroke. Sunstroke. Chronic Enlargement of 
the Tonsils. Chronic Laryngitis. 

Voice, Hoarse. — Dysentery. Bloody Flux. Membranous Croup. 
Acute Laryngitis. Chronic Laryngitis. 

Voice, Loss of. — Diphtheria. 

Voice, Nasal. — Abscesses and Adenoids. Nasal Catarrh. 

Vomiting. — Smallpox. Chronic Bronchitis. Lobar Pneumonia. 
Chronic Catarrh of the Stomach. Chronic Dyspepsia. Drunk- 
ard's Dyspepsia. Cancer of the Stomach. Colic. Gripes. Chol- 
era Morbus. Peritonitis. Jaundice. Gallstones. Biliary Calculi. 
Apoplexy. Hemorrhage of the Brain. Tumors of the Brain. 
Acute Bright's Disease. Chronic Bright's Disease. Diseases of 
the Upper Part of the Throat. Diseases of the Stomach. Acute 
Indigestion in the Stomach. Indigestion in the Intestines. Appen- 
dicitis. Peritonitis. Inflammation of the Bowels. Cerebro- 
spinal Meningitis. Spotted Fever. Scarlet Fever. Mumps. 
Diphtheria. Influenza or La Grippe. Carbolic Acid Poisoning. 
Saltpeter Poisoning. Iodine Poisoning. Lead Poisoning. Cop- 
per, Blue Vitriol, Verdigris Poisoning. Mercury, Corrosive Subli- 
mate Poisoning. Poisonous Mushrooms. Tainted Sausages, 
Tainted Meat, Fish, Mussels, Cheese, and Milk Poisoning. Poison 
Ivy. 

Vomiting, Acid and bitter. — Acute Catarrh of the Stomach. Acute 
Indigestion. 

Vomiting after Coughing. — Whooping Cough. 

Vomiting, Black lumps. — Sulphuric Acid Poisoning. 

Vomiting, "Coffee ground." — Fleer of the Stomach. 

Vomiting, Greenish matter. — Cholera Infantum. Summer Diarrhoea. 
Copper, Blue Vitriol, Verdigris Poisoning. 

Vomiting of Blood. — Acute Gastritis. Ulcer of the Stomach. 

Vomiting of Curds. — Artificial Feeding. 

Vomiting caused by any sort of Liquid. — Cholera Morbus. 

Vomit smells of Phosphorus. — Phosphorus Poisoning. 



ERUPTIVE FEVERS. 



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BOOK III. 

MODERN NURSING AND CARE OF 
THE SICK. 



HOME NURSING. 

G. FREDERIC WHEELER. 

Mills Training School for Nurses, Expert Nurse and Masseur. 

The time has arrived when the value of skillful nursing is appre- 
ciated in every home. We no longer dare trust our sick ones in the 
hands of incompetent, unskilled, although well-meaning, attendants. The 
self-instituted nurse, with no knowledge of her calling, has been sup- 
planted by an intelligent class of men and women who have especially 
prepared themselves for the work. In this class the medical profession 
realize a valuable adjunct to the fraternity, and are beginning to feel 
that their assistance and cooperation are indispensable, and almost essen- 
tial, to the recovery of the patient. At best the physican can spend but a 
few moments each day in a single sick room, and the remaining hours 
must be given over to the care and superintendence of some other person. 

It is not always an easy matter to secure a trained nurse, and many 
families cannot afford to engage one, for skilled service is expensive. 
This, however, should not prevent the sick from having excellent atten- 
tion. It is to this end that these articles on "Home Nursing" are written, 
trusting that, with careful study and intelligent application of the prin- 
ciples set forth, the sick may enjoy better care in their helpless suffering. 

Every family should have some member whom it can call nurse, one 
who will study the requirements of a sick room and strive to become 
proficient in this noble work. The entire care of the family illness should 
not devolve upon the already overworked mother. There must be some 
son or daughter in every family who will be able and willing to share this 
work or take the entire charge of the home hospital, one who is willing 
to prepare to discharge the duties in an efficient manner. No profession 
is more ennobling, and there is no way in which one can do more good 
in the world than to make himself proficiently able to take a watch at 
the bedside, and do it in such a way as to demand trust from both family 
and physician. The latter can treat a case with greater certainty and 
success if he but knows the hourly condition of the patient in his absence. 



226 MODERN NURSING. 

HOW TO PREPARE THE BED. 

With a good mattress to start with, we have the most comfortable 
foundation that can be found. Cover with a light soft pad, so that the 
buttons on the mattress will not irritate the patient. Pin the pad securely 
at the four corners with stout safety pins, this being necessary to pre- 
vent wrinkling. Next cover the pad with a strip of rubber sheeting or 
oilcloth a yard wide, which should be drawn smooth and pinned to the 
edge of the mattress. In case there is no rubber sheeting or oilcloth at 
hand, several layers of paper under the pad will answer the purpose. 
Now cover the bed with a soft, white sheet, drawing it smooth and pin- 
ning securely to the underside of the mattress. 

HOW TO PIN THE SHEET. 

The sheet should be drawn tight, the ends folded under, the sides 
drawn down and the corners mitered, much the same as a paper cover 
would be placed over a book. These corners should be accurately pinned 
to the underside of the mattress with large, stiff safety pins, which will 
hold it in place until it is necessary to remove it. One pin for each corner 
will be sufficient. 

It will not be necessary to pin the sides of this sheet down, as it will 
be held by the "draw-sheet," when the latter is pinned in its place. 

In pinning the sheets to the bed always turn the point of the pin 
away from the center; this lessens the strain at the point, and gives 
a more secure fastening. In bed-making, pin the sheet temporarily first 
at the foot, then draw it smooth, folding carefully, miter the corners, and 
pin it securely at the head. When this is done, it will be an easy matter 
to arrange the corners at the foot of the bed after drawing the sheet 
smooth and tight. Do not use more pins than are necessary, as the sheet 
can be removed with less trouble when a small number is used. 

If the directions are carefully followed, a firm foundation will be 
completed, which will not wrinkle under the patient, will be comfortable, 
and lessen the danger of contracting bedsores. 

Fold a sheet smoothly to about a yard in width — an old soft sheet 
is better for the purpose — and pin across the middle of the bed. This is 
known as the "draw-sheet" ; it can easily be removed without disturbing 
the patient. Safety pins only should be used about the bed, as common, 
short pins will work loose or may injure the patient. 



MAKING THE BED. 227 

Place the top sheet over the bed, tucking it well under the foot of the 
mattress. A warm, light-weight blanket, folded to fit the bed prop- 
erly, will be sufficient cover for the day. An extra blanket should be 
kept in readiness for night use or whenever it is required. Usually 
patients are allowed more covers than are necessary or comfortable. It 
is better to keep them just comfortably warm than to load them down 
with too many blankets. 

Do not use a heavy coverlet or spread on the sick bed. A clean, 
white sheet is much to be preferred, as it is of lighter weight and can 
be changed every day if necessary. A small feather pillow, and a large 
one, always kept fresh and clean, will finish the bed-making. Too much 
care cannot be given to the details of this part of the work, as so much 
of the comfort and ease of the patient depends upon a properly con- 
structed bed. A clean, smooth bed is a joy to a person in health, and 
much more so to an invalid. But aim to keep the bed clean and tidy 
without continually picking and pulling at it, and thus annoying the 
patient. Insist that the covers be kept straight, and there will be little 
trouble in keeping it in order. 

Always have a good supply of clean linen — sheets, pillow slips, and 
towels— on hand, and do not use soiled ones. In fever cases change all 
the linens frequently to prevent reinfection. 

HOW TO CHANGE THE SHEET WITH THE PATIENT IN BED. 

To change the draw-sheet with the patient in bed, unfasten the safety 
pins, have the patient lie flat on his back and draw his knees up. Pass one 
hand under the small of the back, and gently raise him enough to draw 
the sheet out. Always have a fresh one rolled ready to slip under while 
he is in the raised position. This clean sheet should be folded the proper 
width, and rolled tightly. Raise the end of the draw-sheet to be removed, 
and place the fresh one in proper position to be quickly rolled under the 
patient. The end should be pinned properly to the mattress on the side 
from which the nurse is working before the soiled linen is drawn out. 
This will make it much easier to straighten out, and prevent wrinkling. 
After the patient has been lowered to the bed again the opposite side can 
be drawn as smooth as possible and pinned to the underside or lower edge 
of the mattress. 

The object in having the patient draw the knees well up is to allow 
him to assist in raising himself, while the hand under the back relieves 



228 MODERN NURSING. 

the strain. If the patient is unable to help raise himself, it is better to 
call some one in to withdraw the soiled sheet and roll the other under, 
while the nurse raises the patient with one hand under the small of the 
back and the other under the thighs. 

To change the lower sheet, remove the pins from the corners, also 
from the draw-sheet. Roll the soiled linen toward the patient, tucking 
it well under him after turning him on his side, if his condition will admit. 
Have ready a clean, well-aired sheet and a draw-sheet. Roll the draw- 
sheet as before directed, and roll the other sheet lengthwise. Pin it at the 
two corners from which you are working, unroll it toward the patient, 
tucking it under the sheets to be removed. Pin the draw-sheet in place, 
and tuck this also under the patient as directed. Now the patient can 
be gently turned back, the soiled sheets removed, and the fresh ones 
drawn smooth and securely pinned. In removing these sheets, the pillows 
should first be removed from the bed, allowing the patient to lie flat and 
thus aid the nurse. 

With a little practice the bed can be quickly changed with little 
annoyance to the patient and little strain on the nurse. It is the faculty 
of getting at it properly and having even-thing ready at hand that makes 
it easy. There need be no great bustle nor house cleaning aspect, if things 
are rightly managed. Be quiet and systematic in this, as in other sick 
room work. 

BEDSORES, PREVENTION AND MANAGEMENT. 

Patients who are long confined to the bed are subject to ''bedsores. " 
Such sores occur very rarely under the vigilance of a careful nurse, but 
neglect and uncleanliness will be most sure to cause them, and, once 
started, we have a serious annoyance to contend with. 

To prevent bedsores, do not allow the patient to lie in one position 
hour after hour. In case of fracture of the hip, etc., the patient cannot 
be moved much, but, by using rings and air cushions, the point of severe 
contact can be relieved. Whenever possible, turn the patient a little 
every three or four hours to allow the blood to circulate freely through 
the part congested by the weight resting upon it. Bathe the back, hips, 
shoulder, or any part that becomes red from contact with the bed, thor- 
oughly, at least once a day, with warm water and castile soap, and rub 
well with alcohol and zinc stearate ; a solution of alum and alcoholic tannic 
acid powdered over the parts will also toughen the skin and prevent 
abrasion. 



TO TURN A PATIENT IN BED. 229 

Watch the heels, ankles, knee joints, and elbows. They are some- 
times neglected and become sore, especially in patients who are greatly 
emaciated. Keep the bed linens dry and smooth. Use old, soft sheets 
for draw-sheets, and if the elbows or heels begin to show signs of irri- 
tation, pad them with absorbent cotton, the pads held in place with strips 
of adhesive plaster or bandages. 

Massage the back, hips, and shoulders frequently to prevent the blood 
settling in any place. 

The greatest dangers in bedsores are caused by wet beds. The skin 
may become parboiled and abrased, the cells become inflamed, suppura- 
tion take place and gangrene follow. In these cases, every energy must 
be bent to keep the bed and patient clean and dry. Use astringents such 
as alum and tannin in bathing, and a rubber ring to keep the hips ele- 
vated. Never use a feather bed under a patient. The increased heat on 
the back will be greatly conducive to the early formation of sores. 

Should bedsores develop after every care and precaution have been 
taken, it remains only to endeavor to heal them as soon as possible. 
Again, thorough cleanliness is necessary. Cleanse the sores with warm 
water and castile soap ; disinfect with a solution of creolin, one teaspoon- 
f ul to the pint of warm water ; dress with lanolin, oxide of zinc, balsam 
of Peru, or zinc stearate and boracic acid, as the physician may advise. 
Use only sterilized cotton and bandages or strips of adhesive plaster for 
dressing. Linen lint is not so much used since the absorbent cotton has 
been placed on the market. The cotton is much less expensive. Poul- 
tices may be used to remove gangrenous tissue, but not longer. Dress 
at least once a day. Remove all pressure from the part by use of rings, 
and promote circulation in every possible way. If bedsores are neglected 
they become serious through the drain from discharge, and by blood 
poisoning from absorption. 

HOW TO TURN A PATIENT IN BED. 

Some patients will constantly slide down in bed when unable to help 
themselves back. It then becomes necessary to draw them back upon the 
pillow. To do this easily, have the patient clasp his hands behind your 
neck, place your arms around his shoulders under his arms, raise him 
gently, and draw him up to the desired position. 

To lift a patient out of bed, raise him in a sitting position, swing the 
feet over the side of the bed, reach around his back with one arm, place 



230 MODERN NURSING. 

the hands under his arms, and lift him gently. Have the chair or couch 
close by the bedside before he is disturbed. If the patient, for any reason, 
must be lifted bodily from the bed, two can do it very easily. One 
should place an arm under his knees, the other arm under the hips, while 
the nurse should place an arm under his head and the other under his 
shoulders. Do not allow the patient to strain or try to assist, as it will 
make it much more difficult to lift him. Explain to him that he is to lie 
in a supine condition. 

To turn a patient in bed, place one hand under the hip and one under 
the shoulder. Have him turn his head toward the side to which he 
wishes to be moved, and gently roll the body. Do not stand on the side 
toward which he is to be turned and draw him toward you. It can be 
done with more comfort and less annoyance to the patient to turn him 
from you. 

A practical way to move rheumatic patients is to have three assistants, 
one at each corner of the bed. Grasp the corner of the lower sheet firmly 
and pull away from the center, all gently raising it at the same time. This 
is not only hard on the poor sufferer, but also on the ones who do the 
lifting; but it is the easiest way to do it. Have mercy on one who is 
suffering from rheumatism or rheumatic fever and work as gently as 
possible. Fresh linens should be in readiness to be immediately slipped 
under the patient and pinned in place, and the soiled ones can be 
removed after the patient has been lowered to the bed and rested awhile. 
Removing the soiled bedding in these cases is a delicate task and must 
be done with gentleness. 

If a patient is to be raised in bed for the physician to examine the 
lungs from the back, have the patient cross his arms and extend the 
hands. The nurse will then stand at the foot of the bed, grasp the 
hands and draw the patient into a sitting posture leaving the back free 
for examination. By crossing the arms much of the strain and sagging 
of the body is prevented. 

PACKS— HOT AND COLD, 

Hot Packs. — In using any wet packs, the bed must first be protected 
by rubber sheets, oil silk, or oilcloth. In rheumatism, sciatica, neuralgia, 
and localized pains the hot pack is frequently given. 

After protecting the bed, prepare several large squares of flannel; 
old blankets or undervests will answer the purpose. It is better to fold 



HOT AND COLD PACKS. 231 

them into squares of several thicknesses and baste them together, as they 
will be easier to manage, and hold the heat longer. 

Hot packs are sometimes given with saline solution, alcohol (diluted), 
or hot water. Occasionally some volatile oil is used. In rheumatism oil 
of wintergreen or oil of menthol is used. 

To use the pack be careful that the surface is sufficiently cool to 
avoid burning the patient. Place several thicknesses of the pack around 
the affected part and cover with a rubber or oilcloth blanket to keep the 
heat and steam in. Change frequently, never allowing the pack to get 
too cool. When the heat seems to make the patient nervous or faint, 
apply cold cloths to the head and back of the neck and it will relieve him. 
Excessive sweating will reduce the strength rapidly and hasten emacia- 
tion. 

Cold Packs. — Cold packs are much used at the present time in fever 
cases and pneumonia. They are also used directly over localized pains, 
sprains, and on the neck and skull to prevent delirium. Unless rubber 
water bottles are used it will be necessary to protect the bed, as in giv- 
ing a hot pack. 

In case it is desired to place a pneumonia patient in a cold pack, or 
ice jacket, first cover the chest both front and back with a thin layer 
of absorbent cotton. Pack finely chopped ice around him and cover 
with another layer of cotton, which will help to absorb the water from 
the melting ice. 

In case it is desired that ice should not be used directly, a cold pack 
can be used like the hot pack, substituting ice water for the hot. This 
answers very well if constantly changed, and in all cases, save pneumonia, 
may prove more desirable. However, one must be governed by the 
physician. Whenever practicable, we advise the use of water bottles, 
since they protect the bed from water, and thus lessen annoyance and 
reduce liability to bedsores. 

BRAND'S BATH FOR TYPHOID (MODIFIED). 

The American rule for giving Brand's bath for typhoid differs very 
little from the German save in the temperature of the water. In cases 
where the heart is a little weak or the patient hypersensitive, half an 
ounce of brandy or whisky should be given a few minutes before the 
patient is put into the tub. 

Place a portable bath tub beside the bed, fill it about half full of water, 



232 MODERN NURSING. 

and put into it sufficient ice to lower the temperature of the water to 
whatever point the physicians may prescribe for the bath. Have a pail 
of chopped ice at hand to put into the tub after the patient has been 
submerged, in quantity sufficient to bring the temperature down five 
degrees lower. A bath thermometer is an absolute necessity in giving tub 
baths. 

Prepare the patient by removing the clothing and giving him a brisk 
friction rub from head to foot until the skin is very red. Be careful not 
to use any weight over the bowels. A towel should be pinned about the 
loins, an ice cap applied to the head and neck, and, with some one to assist, 
he should be gently but quickly lifted from the bed and as quickly sub- 
merged to the neck in the bath. The shock is greater to some people 
than to others, and the pulse must be closely watched, and if it becomes 
hard or depressed the patient should be removed from the tub at once, 
and another half ounce of whisky given. 

While the patient is in the tub, keep up the friction constantly, from 
head to feet. This brings the blood to the surface and gives it a chance 
to be cooled. Keep the patient in the bath from 12 to 20 minutes if he 
stands it well, then gently lift him back into bed and roll him in a 
warm blanket. He will likely shiver for a few minutes, his lips will be 
purple, but he will soon get warm and probably go to sleep. The tem- 
perature should be taken an hour after the bath and be recorded. The 
rule for administering the ice tub bath is generally, "When the tempera- 
ture reaches 103.6 degrees F., it is an indication that the Brand bath 
is required." These are never given more frequently than every three 
hours, and should not be attempted by non-professionals, except in the 
presence of a physician, as there is more or less danger of collapse from 
the shock. 

BANDAGES. 

Every home should have on hand a stock of bandages and cloths for 
emergencies. Bandages, lint, and absorbent cotton can be obtained from 
almost every drug store now, and are not very expensive, but old sheets 
torn into strips from one to four inches wide and the ravelings pulled 
from the edge make good bandages. Cheese cloth or gauze make the best, 
however. 

When the bandages have been cut or torn into proper widths, they 
should be wound tightly and evenly over a lead pencil, wrapped in a clean 
piece of paper and tied separately and placed in a hot oven until 



. BANDAGES. 233 

thoroughly heated through. The paper should not be removed until 
the bandages are required for use. 

The head is perhaps the most difficult part to bandage. This is done 
in. what we term a "re-cur." First wind the bandage around the head 
over the forehead and above the ears about two or three times. Hold the 
bandage in front with the thumb, let it extend up over the head and 
down to the bandage in the back, where it should be held in place with 
the middle finger. Next, put it up over the head again and hold this 
second end with the thumb; back again in re-cur and put it around the 
forehead once or twice, until these ends are held in place. Repeat the 
process until the scalp is covered. 

In bandaging always unroll the bandages from you. Do not wind the 
bandage around, but cross and recross, keeping it firm and tight. In 
case of bandaging a taper, as in the forearm or leg, it is necessary to 
frequently tighten the bandage by making a half turn of the 
roll, thus crossing the bandage upon itself at an angle. This tends to 
draw the opposite edge down. Large dressings like laparotomy, or spica 
bandaging, require the service of an experienced person. The physician 
can give the young nurse a practical demonstration, which will greatly 
aid her in bandaging. In bandaging a hand or finger, let it go around 
the wrist several times. This will help hold it in place. 

A "T" bandage is made with two strips of cloth, one long enough to 
go around the waist and the other sewed to the middle of the waist 
bandage and long enough to go over the dressings between the thighs 
and pin to the waist bandage. 

A "four-tail" is any bandage with the ends stripped into tails for 
tying. They are named according to the number of strips into which 
the ends are torn, and may be four, six, or eight tail bandages. They 
are used to tie other bandages on, instead of sewing them or using pins, 
and are very convenient. 

(See "Emergencies," page 572. See illustrations.) 

Rubber Bandages. — Rubber bandages are very little used, save in 
preparing for operation by Esmarch's plan, or to prevent swelling, as in 
varicose veins in the legs, and for support, as of a hernia. When used, 
care should be taken that they are not doubled at right angles with them- 
serves, or the elastic freedom will be lost. Silk or elastic stockings and 
supports have replaced the rubber bandages, and are in every way to be 
preferred. 



234 MODERN NURSING. 



STUPES. 



Stupes are hot applications used for their counter-irritating effects, 
to allay pain, and remove gases. Turpentine, chloroform, laudanum, oil 
of wintergreen (ol. Gaultheria), tincture of capsicum, menthol, and 
many other agents are used. 

Prepare flannels as for a hot pack, wring them as dry as possible from 
very hot water, and sprinkle over one side a few drops of whichever 
agent the physician may prescribe. Be careful that the patient is not 
blistered. Never apply chloroform directly to the skin. Hold the hot 
flannel an inch or two away from the part to be treated. 

Turpentine is much used in tympanites of typhoid or other intestinal 
disturbances where large quantities collect and cause distention of the 
abdomen. It is also used internally by enema. 

Laudanum is used where excessive pain demands something to quiet 
the nerves and deaden the sensation, as in abscesses, boils, carbuncles, 
and fractures. Wring the cloth out as hot as possible, sprinkle it well 
with laudanum and apply directly over the localized pain. As soon as the 
pain begins to be less, remove the cloth, replacing it with a dry, warm 
flannel. 

ENEMATA. 

Enemata or injections are used to relieve the colon of fecal matter in 
constipation, or to cause a quick, ready movement of the bowels. Enemata 
are usually divided into two classes for convenience : viz., simple and 
nutritive. 

In giving injections to very small children, the hard rubber syringe 
and a Xo. 14 male catheter, or a small rectal tube are necessary. For 
adults, a bag, or Davidson syringe, and a long rubber rectal tube are 
indispensable. 

To administer a simple enema, place the patient on his left side, with 
hips slightly raised. Protect the bed with rubber sheet or bath towel. 
Prepare the solution according to direction below. Have the tempera- 
ture of the solution about 108 degrees, as the syringe will cool it to some 
extent. If a Davidson syringe is to be used, place the rectal tube 
over the end and press the bulb until the solution passes through freely 
without being accompanied by air. Keep the suction end in the solution, 
never allowing it to come to the surface, or air will get into the syringe. 
Oil the rectal tube with olive oil or vaseline, and insert gently into the 



ENEMATA. 235 

rectum. As soon as it passes the sphincter muscle it will pass readily 
into the descending colon, unless it be obstructed by hard fecal matter. 
Care should be taken that the tube does not double on itself. This can be 
obviated to a certain degree by beginning to press the bulb gently as 
soon as the end of the tube passes through the sphincter muscle. When 
the tube has been inserted its full length, raise the bowl about a foot 
and allow the solution to slowly siphon out. By giving it slowly much 
better results will be obtained. 

The chief objection to the use of the bag or douche syringe is that 
the general inclination is to allow the solution to run too fast, causing 
pain for the patient and poor results from the enema. 

The amount of solution given depends largely upon the patient's 
ability to retain it for a few minutes. Small children may take half a 
pint, while, an adult will take from three pints to two quarts. Do not let 
the patient think about what is going on. Lead his mind from it by con- 
versation, and it will be found that a larger quantity can easily be given. 
Insist that he keep his mouth open, as there will be less strain. 

In preparing solution for rectal injection, always use water that has 
been boiled. Do not use salt, if soap is to be used, or a gummy substance 
will form, filling the syringe. 

When a simple enema is called for it usually means three pints of 
warm water, to which has been added white castile soap until it is 
smooth and a suds easily formed. Sometimes a cup of sweet milk is 
added. 

For obstinate cases use one quart water, no degrees, two ounces olive 
oil, and one ounce of glycerine. Be sure that the syringe is thoroughly 
cleaned after using olive oil, as it will quickly rot the rubber, and the 
syringe will leak. 

In cases of impacted faeces with little peristaltic action, one quart to 
two ounces of Epsom salts, dissolved in a quart of warm water, slowly 
given and retained for a few minutes, will usually prove effective. In 
some cases it is necessary to resort to ox gall one ounce to water one pint 
for quick results. 

In cases of chronic constipation, glycerine suppositories are invaluable. 
They can be used with little inconvenience, and often prevent hemor- 
rhoids, or the reappearance of same. 

Xutritive enemata are only given upon advice and direction of the 
physician in cases physically incapable of taking food into the stomach, 
or of digesting the same. There are predigested foods on the market 



236 MODERN NURSING. 

which are now much used, and are to be preferred. However, if they 
are not at hand, the white of eggs (some physicians use the yolks), 
milk or cream, beef tea, and strong, black coffee, with a little brandy, 
can be used. A nutrient enema should never be larger than can be 
easily retained. Small children will retain from one to two ounces, 
while an adult will retain from four to six ounces, and it should not 
be given more frequently than once in five hours. 

In case of exhaustion, nausea, and continued vomiting, shock. from 
surgical operation, and depression after an anesthetic a few ounces of 
strong, black coffee will prove very useful when given per rectum. Pep- 
sin is often added to the nutrient enema to digest the food. 

HYPODERMIC INJECTIONS. 

The use of the hypodermic needle has become quite common, and 
quick results from stimulants are obtained by injecting them under the 
skin. Triturates and tablets are now provided so that physicians feel 
quite safe in prescribing. To the inexperienced the needle looks horrible. 
There need be no horror or pain from its use. Prepare the solution 
as directed, clean the needle with alcohol or carbolic acid, rub the spot on 
the arm, or whatever part the needle is to pierce, with alcohol and a bit 
of gauze or cotton to bring the blood to the surface, pinch the flesh up 
between the thumb and index finger and insert the needle with a quick 
motion. The patient will scarcely feel it. Press the piston slowly, allow- 
ing the solution to diffuse, withdraw the needle quickly, and again rub 
the place with alcohol. If these directions are carefully followed, there 
need be no pain or infection. The hypodermic should never be used, save 
by the direction of the physician. 

COUNTER-IRRITATION. 

Counter-irritants are usually applied over the seat of the disorder, 
but are not infrequently placed on some remote part to obtain the so- 
called revulsive action. As, for instance, mustard footbath and draughts 
on the feet relieve the head. Mustard is more frequently used than any 
other rubefacient, although liniments, camphorated oils, ammonia, tur- 
pentine, etc., are often used. 

To make a mustard plaster, or sinapism, use one part powdered 
mustard to from two to five parts of flour, according to strength desired, 



BLISTERS. 237 

Mix the paste with tepid water, and spread on a thin cloth. Cover with 
a piece of muslin and apply to part desired. It will likely feel cool at first, 
but will soon get warm. Do not use hot water or vinegar, as the full 
action of the mustard is desired. They destroy much of the volatile 
action. Do not leave the plaster on the patient long enough to blister, 
for a sore thus produced is painful and slow to heal. When the mustard 
has caused a good irritation, remove the plaster. If it burns too much, 
sponge the skin with vinegar to counteract the mustard. 

In preparing mustard paste for children, mix with glycerine, and the 
action will be less severe. 

To make a cayenne pepper plaster, mix the same as mustard, using 
a tablespoonful of cayenne in a thin paste with flour. Or the pepper 
may be stitched into a flannel bag, and this wrung out in warm water and 
applied. Mustard paper and capsicum vaseline are good substitutes and 
easy to use. 

BLISTERS. 

The agent most generally employed in blistering is cantharides, and 
should never be applied where the skin is broken or tender. A piece of 
oiled tissue paper between the plaster and the skin will not only protect 
the skin but accelerate the action of the blister. 

In preparing to blister, wash the part thoroughly with castile soap 
and water, and dry it well. Shave the part if there be any growth of 
hair upon it. Secure the cantharides in place by a bandage instead of 
strips of adhesive plaster, thus lessening the danger of tearing the skin 
in removing it. 

Blistering should take place in from 6 to 8 hours. If not within 12 
hours remove the blister and apply a poultice, when the desired effect will 
usually be produced. In removing the plaster, be careful not to tear the 
skin. Remove all particles of the cantharides with a bit of oil. When 
the blister is full of serum, a small incision may be made at the lowest 
point to allow it to drain out, or it may be left to be reabsorbed. 

Blisters are rarely used now, and only upon direction of a physician. 
If it is desired to raise a blister quickly, it can be done by moistening a 
bit of gauze or cotton with chloroform or ammonia and applying to the part 
to be blistered. These blisters are more in the nature of a burn, and if the 
applications are left long on the part they will burn deeply into the 
tissue. 



: 3 8 MODERN NURSING, 



CUPPING. 



The process known as cupping is frequently used to relieve pain and 
congestion. It requires skill, and especially wet cupping is never given 
except in the presence of a physician. Cupping glasses are required for 
this operation, though small tumblers or wineglasses with smooth edges 
can be used in the absence of any regular apparatus. 

Have at hand a lighted taper or candle, a little alcohol in a glass, and 
a small swab or camel's-hair brush. See that the glasses are clean and 
dry. Prepare the patient by exposing the part to be cupped, dip the 
swab or brush into the alcohol and squeeze the greater part of the spirits 
out of it. Rub the inside of the glass with the brush, keeping it well 
away from the edge, and not allowing any of the alcohol to trickle 
down the side of the glass upon turning it down. Pass the glass over 
the flame of the taper, when a blue flame will immediately appear, but 
will last only three or four seconds; hence the necessity of working 
lively. 

Place the cup over the part to be cupped, when it will be seen that 
the oxygen having been burned out of the glass there will be sufficient 
suction to draw the flesh well up. Prepare another glass in like manner, 
always being careful not to use alcohol enough to heat the edge of the 
glass or drop on the patient, for there is no excuse for burning him. Do 
not let the glasses remain long enough to cause discoloration. Grasp 
the glass by the top and with the fingers of the other hand press the 
flesh away from the edge. As soon as a bit of air enters, the glasses will 
be released. Do not place a second glass within the ring formed by 
another. Glasses furnished with rubber bulbs for exhausting the air can 
be had instead of using alcohol. 

In wet cupping the same apparatus is used, in addition to which 
there must be a scarificator, absorbent cotton, and adhesive straps. After 
cupping, the scarificator will be applied, making a series of little cuts, and 
the cups replaced until sufficient blood has been extracted. A dry dress- 
ing will usually suffice, though sometimes it is better to dress in some 
ointment like lanolin or carbo-vaseline. Wet cupping is seldom used, 
except to relieve inflammation of the kidneys. 

LEECHES. 

Leeches are not so much used now as they were formerly. Those 
used are of two kinds, the American and the foreign. The latter are to 



POULTICES. 239 

be preferred in most cases, since they are more voracious, and will draw 
four or five times their own weight of blood. Leeches will draw more 
blood from a child than from an adult, owing to the thinness and greater 
vascularity of the skin. For this reason domestic leeches are chosen for 
children. 

Leeches should never be applied over large blood vessels, but over a 
bony surface upon which pressure can be made in case it is necessary 
to check a hemorrhage. 

Sometimes it is difficult to make leeches bite. Fumes of sulphur, 
vinegar, strong odors, or tobacco will affect them. The leech also 
objects to certain drugs, which may have been taken internally. A slight 
scratch, just enough to give them a taste of blood, is usually sufficient 
inducement. 

The part to which the leech is to be applied should be thoroughly 
washed and dried before the leeches are applied. The leeches should 
also be washed and dried in the folds of a towel, and never handled. If 
they are to be used in the mouth or nose it is well to put a silk thread 
through the tail to prevent them from being swallowed. In case one 
should be swallowed, it will become harmless by drinking a quantity 
of salt and water. 

When they are full they will drop off. Never attempt to pull them 
off by force, or the teeth will be left in the wound and abscesses may form, 
or erysipelas result from it. The bite leaves a permanent star-shaped 
scar. If it is desired to remove them before they are full, sprinkle a little 
salt over their heads, when they will release themselves and drop off. If 
the hemorrhage continues, it can be checked by hot or cold applications, 
or by touching with nitrate of silver. 

CATAPLASMS (POULTICES). 

Cataplasms or poultices are a convenient form of applying warmth 
and moisture. Their effect is to soften the tissues and dilate the capil- 
laries, relaxing tension of inflamed parts, and relieving pain. Early 
application oftentimes checks the progress of inflammation. 

When suppuration begins, they facilitate the passage of pus to the 
surface and limit the spread of induration. Poultices should be applied 
as hot as can be borne, and covered with an oilcloth or rubber to keep 
the heat and moisture in. Poulticing should not be continued too long, 
as it renders the flesh sodden and irritable, ?nd may cause sloughing. 



2 4 o MODERN NURSING. 

Gauze, muslin, spongiopilin, which is made of sponge and wool 
felted together and one surface coated with a preparation of rubber, are 
used in preparing poultices, which may be made of a variety of ingredi- 
ents. Linseed meal is very generally used, and when of good quality 
makes excellent material. It should be well cooked. It is very glutinous, 
and should be of the consistency of dough. Spread about half an inch 
thick upon a piece of muslin of the required size, leaving a margin of an 
inch on all sides. It is better to cover it with a coarse, net like mosquito 
netting or tulle, though it may be applied directly to the skin. If it dries 
and adheres to the skin, a little oil will remove it. Keep the poultice 
warm by the use of hot water bottle or hot flannels. 

Poultice jackets are sometimes ordered for the chest. They should 
be made of two pieces, one for the front and one for the back. These 
can be tied over the shoulders with tapes to prevent them from slipping 
down. 

Bread poultices are more bland than linseed, but cool quickly and hold 
less moisture. They dry and fill the bed with crumbs. Milk should not 
be used in these poultices, as it soon sours. Weak carbolic solution may 
be used when a disinfectant is desired. 

Yeast poultice is often used to hasten sloughing in gangrene. Mix 
six ounces of yeast with an equal amount of warm water, and stir into 
it fourteen ounces of flour. Let it stand near the fire until it rises. Apply 
while fermenting. 

Starch makes a mild poultice and retains heat well. It is much used 
in irritating skin diseases. Mix as for laundry use. 

Slippery elm, Indian and oat meal, rye, and other flours are used, 
and are cooked the same as linseed meal. 

Scraped carrots, boiled or raw, are thought to have a peculiar cleans- 
ing effect. Hops, when sewed into a bag and wrung out in hot water, 
have a soothing effect. Laudanum is used for its sedative effect. Pow- 
dered hemlock leaves, one part to three of linseed meal, have something of 
the same nature. Constitutional effects from the drugs must be watched 
out for when they are used. There are many other kinds, such as horse- 
radish or onion poultices, which are used for their stimulating properties, 
but for ordinary purposes the linseed meal is preferred. 

Poultices should be renewed whenever they get cold or hard. If 
there is a large discharge of pus or purulent matter, they should also be 
frequently changed. 



ICE BAG. 241 

SWABS AND MOUTH WASHING. 

To keep a patient's mouth clean in fever cases is very important. 
After taking milk or gruel the patient should cleanse the mouth with 
fresh water, or a mild salt solution. The teeth should be cleaned, and 
the sordes removed once or twice a day. This can be done with a piece 
of gauze over the index finger, or by using a swab made by winding the 
end of a stick or lead pencil with absorbent cotton or gauze and carefully 
sponging the mouth. 

Tincture of myrrh is excellent for cleaning the teeth, and good for 
the gums, acting as an astringent. A wash made of lemon juice, 
glycerine, and ice water, equal parts of each, is excellent and agreeable. 
Washing the mouth with boracic acid solution also helps to keep it 
fresh, and is very soothing and healing. If the tongue and lips are dry 
and inclined to crack, use cocoa butter to soften them. Do not use 
vaseline or glycerine for this purpose. 

ICE BAG. 

The ice bag is a rubber cap or helmet that is used for applying ice 
to the head, and is more convenient than the rubber water bottle for this 
purpose, since the mouth or opening is larger. 

To use the ice cap, fill it full of finely chopped ice, mixed with a 
small quantity of table salt. It is always well to place a sponge or some 
absorbent cotton in the mouth of the bag 
before closing it, as it will absorb some of 
the water and prevent it from leaking. 

Place a moist cloth or moist cotton over 
the head and apply the ice cap, tying it in 
place with bandages if necessary. The 
moist cloth will aid in keeping the head 
cool and prevent contact of rubber with the IG * CE AG * 

flesh. Sometimes, when the cap is not nicely adjusted, there is danger 
from frost bite. 

In fever cases, delirium, or injury to the skull the ice cap or helmet is 
indispensable. An improvised bag can be made of oil silk, rubber, or 
other material, but it will generally leak and prove unsatisfactory. 

EMBROCATIONS— LINIMENTS. 

When any remedy in liquid form is applied to a part by rubbing it 
in, it is called a liniment, and may be either soothing or stimulating, or a 




242 



MODERN NURSING. 



counter-irritant. Liniments usually contain poisonous ingredients, and 

care should be taken that they are not left where they will be taken 

internally by mistake. The hands should be well washed after using. 

For rubbing in liniments see article on "Massage" (local), page 272. 

ENDERMIC MEDICATION. 

Endermic medication, or feeding through the agency of the skin, is 
now used only in rare cases. Some constitutional diseases are still 
treated with mercurial inunction, and consumptives are given hot baths 
with massage and cod-liver oil applied to the skin. In either instance 
the physician should prescribe the treatment. 

FOMENTATION. 

See "Hot Pack," page 230. 

CLYSTERS. 

See "Enemata," page 234. 

SINAPISM. 

See "Counter-irritation," page 236. 




Fig. 60. Nasal Douche. 



ATOMIZERS AND SPRAYS. 

See "Nasal Douche." 



NASAL DOUCHE OR SPRAY. 

The nasal douche is now rarely 
prescribed because of the danger 
which attends it. It is more or less 
likely to affect the eustachian tube and 
cause deafness. Pain in the ear 
should be a sign of discontinuance of 
any nasal treatment. 

The nasal douche has been super- 
seded by the post-nasal spray, which 
is far less dangerous and more effec- 
tive. 

Atomizers for spraying the nose 
and throat, with full directions as to 
their use and management, can be 



found in any drug store, and are inexpensive. 



SICK ROOM UTENSILS. 



243 



Gargles for the throat are not so effective as the spray of the atomizer, 
and, by spraying, the teeth are protected from injury so likely to occur 
from the use of iron and acids in gargles. The mouth should always 
be well rinsed with an alkaline solution like soda or limewater whenever 
acids are used near the teeth. 

NECESSARY UTENSILS. 

There are a few utensils indispensable to the sick room. These are 
inexpensive and any family cannot afford to be without them. 

One or more 2-quart rubber water bottles for either hot or cold 
applications as desired seem almost necessary. Cloth covered ones can 
now be had and are much to be pre- 
ferred, since it lessens the danger of 
burning or blistering when hot 
water is used. In case the bag is 
not cloth covered, a cover should be 
made to slip over it before using 
near the patient. Do not risk wrap- 
ping in a towel. They will some- 
times slip out and accidents occur. 

In using hot water, never fill 
more than half full, then lay the 
bottle flat until the water comes 
up to the nozzle before putting in 
the stopper. This excludes the air 
and steam, lessens the danger of 
explosion, and also keeps the water 
hot for a greater length of time. 

In absence of rubber bottles, or when a greater number is needed 
than is at hand, quart glass bottles that can be 
tightly corked, wrapped in towels and securely pinned 
with safety pins, will prove useful. Care should be 
exercised in filling, not to use water hot enough to 
break bottles and scald the patient. To burn a patient 
is unpardonable, and a nurse who is careless enough 
to do so should not be trusted in a sick room. 

In selecting a bedpan, the modern, square, porce- 
lain pan is preferred, as it is lighter, can be quickly 
Medicine Glass. warmed, and is more comfortable and more durable. 




Fig. 61. Atomizer or Spray. 




244 MODERN NURSING. 

In absence of a urinal, wide-mouthed or large-necked pickle bottles 
prove very satisfactory and convenient. 

A bag syringe or douche is indispensable. A bulb or Davidson syringe 
and a glass or hard rubber syringe should also be found among the 
utensils. 

A graduated medicine glass for liquids, a glass tube for taking iron, 
administering liquids to patients unable to be raised, and a china feeding 
cup can all be had for a few cents and prove most valuable in sickness. 

A bath bowl, some pure, not strongly-scented toilet soap, talcum 
powder, etc., should always be provided. A medium-sized, fine sponge, 
and several yards of bleached gauze or old linen, should be found among 
the bath perquisites. 

A covered slop jar, either porcelain or china, one that will stand 
chloride of lime or other disinfectants, will complete the utensils which 
seem absolutely necessary. 

A sputum cup is a necessary 'article in every sick room. China or 

porcelain ones with 

covers can be found 

at any china store. 

A bit of chloride of 

lime or some other 
Fig. 63. Nose Syringe. 

disinfectant should 
be placed in the cup each time after it is cleaned. Old cloths, gauze, 
etc., should be always kept on hand to be used for sputum. It is 
better to burn such cloths than to wash them. 
For disinfecting see pages 158 to 162. 

THE CHART. 

A carefully and accurately kept chart is a most valuable aid to the 
physician. It has been remarked before that the physician can spend 
but a few minutes each day with the patient, and that, usually, at about 
the same hour each morning or afternoon. Consequently, he has no 
means of knowing just what takes place in his absence save through a 
careful report by sone one who has watched the patient, taken his tem- 
perature, and counted his pulse at regular intervals. A nurse cannot 
trust details to memory, hence another necessity for having a daily record. 

Chart sheets can be found at almost any apothecaries', or can be 
drawn up by the nurse when not at hand. A most convenient form, 
one that is simple and easy to keep, is given on pages 246 and 247. 




THE THERMOMETER. 



245 



Write the name of the patient and number the sheet. Write name 
of attending physician and his diagnosis of the disease. In their proper 
spaces fill in the month, day of month, day of week, and hour when the 
temperature, pulse, and respiration (T. P. R.) are taken, and record 
them in the spaces marked T. P. R. Use the decimal system in record- 
ing fractions of a degree of temperature, as it will not then conflict with 
the small lines, which divide the degrees on the chart into fifths or two- 
tenths. 

The dotted line running across the page at 98. 6° is the normal tem- 
perature line. Any temperature above or below this point shows an 
irregularity in the system, and the farther the temperature stands from 
this point the greater the danger, usually. 

After recording the figures as per direction, place a dot on the proper 
line showing the maximum height of 
temperature at the time the record was 
made. Connect this dot with the one 
denoting the previous record by a 
heavy line. It is better to use red 
ink for night records when it is pos- 
sible, for it then gives the physician a 
correct knowledge of the state of af- 
fairs at a glance, and greatly assists 
him in deciding what steps are neces- 
sary to be taken. 

When baths are given to reduce the temperature, connect the dots 
which show the point the temperature has reached before and after the 
bath, by dots instead of the heavy lines. This will show the effect of the 
bath. 

On the reverse side of the sheet a record should be kept of the medi- 
cines administered, baths given, enemata, and cathartics and their results 
and any irregular symptoms that are noted by the nurse. In fact, any- 
thing that the physician should know that is not kept on the other side. 

The importance of a well-kept chart cannot be overestimated. In- 
accurate reports are not only useless, but are often dangerous. Every 
physician recognizes and appreciates a true record — and every patient 
benefits thereby. 

(See Diagram.) 




Fig. 64. Oil Atomizer. 



246 



MODERN NURSING. 



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Specimen Chart 
Showing Crisis of Pneumonia. 



Figures in left-hand column mark the Temperature in Degrees. 

T — Temperature. 

P— Pulse. 

R— -Number of Respirations per Minute. 



SPECIMEN CHART. 



247 



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Specimen Chart 

Showing Crisis of Pneumonia. 



Dotted line across page is Normal Temperature of 98.4* F. 
Observations are recorded ever)' four hours during day and night. 



2 4 8 



MODERN NURSING. 



CLINICAL THERMOMETER. 

Every family should possess a clinical thermometer and everybody 
should know how to read one. Many times a person feels indisposed 
when really nothing is the matter with him. By trying" the temperature 
one can quickly tell if there is likely to be any serious trouble by the 
reading of the thermometer. If there is considerable rise in the tem- 
perature above the normal point, it is better to consult a physician. 

To use the thermometer, shake the mercury down below the normal 
point, being very careful not to shake the thermometer out of the hand. 
Place it under the tongue of the patient, except in 
cases of small children, and have him close his lips 
tightly over it. Let him hold it there for a full 
minute. Removing it, hold it so that the light will 
fall on it. If it be a triangular affair turn one side 
of the triangle up, and move from side to side 
gently till the mercury can be seen. Note to what 
degree and fraction it has risen, remembering the 
thermometer is graduated by fifths, — each step 
equals two-fifths of a degree. The twist in the tube 
above the bulb prevents the mercury from again 
falling till it has been shaken down. In children 
and delirious patients the thermometer may be 
placed in the armpit and held for four or five 
minutes. 

To clean the thermometer use a soft napkin or cloth moistened with 
water, or, in infectious or contagious diseases, some disinfecting liquid 
should be used. Do not use hot water, or the bulb will break. Do not 
use alcohol, or the figures will be removed. Clean thoroughly each 
time immediately after using, and shake the mercury down ready for 
use again. Always take and record temperatures at regular intervals, 
say every three or four hours, and always at the same time each day. 




Fig. 65. 

Cloth Covered Hot 

Water Bag. 



THE PULSE. 

The pulse indicates the action and condition of the heart, and is 
a lifetime study. That the pulsations are about 70 per minute and 
regular in force and intervals is about all we can say to you in regard 
to the normal pulse. Any change from this is an indication that there 
is trouble. 



RESPIRATION. 249 

To feel the pulse, place the tip of the middle finger on the palmar 
side of the wrist, about three-fourths of an inch from the inner edge. 
Do not use the thumb or index finger in taking the pulse, as there is 
a slight pulsation in those fingers that makes the true pulse feel uncertain. 

Count each pulsation for a full minute and record. Each time note if 
the pulse feels the same. In fever cases, and other cases where there 
is toxic poisoning, the lift of the pulse will be quick and decided, with. 
perhaps, no increase in frequency. Such a pulse calls for expert attend- 
ance, as does one which beats so lightly it can scarcely be felt. 

An intermittent pulse is one that pulsates regularly for a few times, 
then skips a beat, repeating at intervals. This should be reported to the 
physician. 

Inexperienced or untrained nurses should not administer heart stimu- 
lants except under the direction of the physician. 

One can learn a great deal about the pulse by noting the quality or 
feeling of the pulse each time it is counted. Always let the arm rest 
comfortably when counting the pulse, and do not count for record 
immediately after the patient has been sitting up or is excited in any way. 



THE RESPIRATION. 

The number of respirations per minute should be counted when the 
patient is unaware of it. This can be done by watching the rise and fall 
of the chest. The normal respiration in an adult is from 14 to 18 per 
minute. In a child it is more, varying according to age. 

The quality of the respiration is also a study. In pneumonia and 
other pulmonary diseases there will be a marked increase of respirations. 
In case of worms in children, or any bowel trouble in infants, there is a 
marked increase. Any trouble with the heart, pleurisy, etc., causes short- 
ness, gasping, or catching of the breath. 

In counting for record, always count for a full minute. Do not record 
the respirations of a sleeping patient, unless it is done every time when 
he is sleeping. 

MEDICATION. 

It is never advisable to keep medicines in the sick room. The sight 
is annoying to the patient, and gives the room a drug store odor. They 
should be kept well covered in a cool, clean place. Remember cool drinks 
are appreciated by the sick, and tepid liquids are always distasteful. 



250 MODERN NURSING. 

Hence, if the medicines are disagreeable to the taste, much of the annoy- 
ance will be removed by keeping them cold. 

Several large-necked bottles, carefully labeled for holding tablets, 
are indispensable. Poisons and disinfectants should be marked as such, 
and kept where danger from mistakes will be impossible. All cups, 
spoons, and glasses used about the patient should be kept clean and 
polished. This means a great deal to the sick. 

It is a bad practice to feed medicines from a spoon. Small, graduated 
glasses can be obtained from any glassware or drug store, and are indis- 
pensable in dispensing liquids. One swallow from a glass is much more 
easily taken than two or three from a spoon, especially if the medicine 
is bitter, or unpleasant in any way. 

All medicines containing iron should be taken through a straw, or 
glass tube, to keep the liquid away from the teeth. Milk and other liquids 
may be easily taken this way by patients unable to sit up, or to be raised 
comfortably. 

Dry powders given on the tongue often choke the patient. It is 
better to moisten with a little water or glycerine before administering. 
In giving powders, or tablets, have the patient extend the tongue for- 
ward, thus giving opportunity to drop them well back, and preventing 
them from getting under the tongue, or in the teeth. 

Oils are obnoxious to most people. They should be given in capsules 
when possible. A little strong, black coffee, taken before and after the 
oil, will remove the taste. A teaspoonful of sherry, or the juice of an 
orange, are also pleasant agents for covering the taste of oils. 

In administering bitter medicines, bear in mind it is the roof of the 
mouth and back of the tongue that sense bitter, and a straw- or glass 
tube can be used to advantage by those who object to it. 

Much care should be used in administering the anodynes, or any 
astringent medicines, since there is more or less danger of strangulation. 
A little knowledge of medicine will aid the nurse in devising simple, 
ingenious ways of covering the taste, greatly to the relief and comfort 
of the patient. 

There are other ways of administering medicines than by the mouth. 
Sometimes it is necessary to administer by rectum, by the hypodermic 
needle, or through skin absorption. Usually, however, these modes will 
be given under the direct supervision of the physician. 

A word on the giving of injections or enemata may prove useful. 
Usually the patient should be placed on his left side, with hips slightly 



URINE— FAECES— BATHS. 25 1 

raised. A bulb, or Davidson syringe, is best, especially in the hands of 
the inexperienced. Prepare the solution, which may consist of from 
one to three pints of warm water into which white castile soap has been 
rubbed till a smooth suds has been formed, or it may be made of milk 
and water with oils, or in any other way the physician may prescribe. 

Place a bath towel under the hips of the patient to prevent soiling the 
bed. Oil the tip of the syringe and insert gently, not allowing the 
patient to hold his breath, which tightens the muscles. The end of the 
syringe should not be taken from the solution to allow air to get into 
the bulb. Press the bulb gently, and, when the solution is started, raise 
the bowl about a foot and allow the contents to slowly syphon out. This 
usually brings good results. 

URINE. 

From time to time the physician will wish to see a specimen of the 
patient's urine, and possibly want to make a chemical examination of it. 
Clean two or three four-ounce bottles and have ready for saving samples 
when called for. Always save the morning discharge for the doctor. 

Measure the quantity passed in twenty-four hours and record same 
on chart. Learn to observe whether the color is light or dark, straw 
color or amber, clear or cloudy, if there is a vegetable or ammoniacal odor. 
In fact, to keep posted as to every detail so that information of a valuable 
nature can be given if the physician should ask for it. 

In cases with high temperature the quantity will be small and very 
dark, almost wine color. Certain drugs will increase the quantity. Niter, 
Rochelle salts, etc., act in this direction. 

FAECES. 

What is said of watching the character of the urine applies also to 
watching the stools. Observe the color, condition, whether formed or 
liquid, if the food is digested or in chunks, etc. Report diarrhoea or 
constipation, and keep record of number of movements of bowels each 
day. 

For disinfecting urine and stools in contagious and infectious diseases 
see page 163. 

BATHS. 

How and When to Bathe — Baths are now extensively used in 
treatment of disease as well as for cleanliness. It is to be assumed that 



252 MODERN NURSING. 

every person has a full bath at least once a week, otherwise the pores of 
the skin become clogged and cannot perform their proper function. 
Cleanliness is a prime requisite to the health of the body, and to the 
social status in all civilized countries. 

Baths as a therapeutic agent are very valuable when judiciously 
employed. They should be given only by order of the physician, but 
when ordered cannot be given too faithfully. 

The German rule for baths is modified in this country. According 
to Brand's idea, a cold bath should be given whenever the temperature 
reaches 103 ° F. The Germans, too, use a much colder bath than is com- 
monly used in this country. 

In preparing a patient for any cold bath, apply friction, either by 
using a coarse towel or the hands, to the entire surface of the body, to 
increase circulation. Place a cold compress on the head and back of the 
neck. If a tub bath is ordered it will be given only in the presence of 
a physician in the absence of a trained nurse, but bed baths, sprinkle, 
evaporation, and sponge baths can be successfully given by anyone with 
average common sense and a little practice. 

In fever cases, especially typhoid, when the patient needs bed baths, it 
will be necessary to know how to prepare the bed. In cases of extreme 
temperature a cold sprinkle-bath is often advised. To prepare for this 
use a large rubber blanket or oilcloth. Lay it flat on the floor and cover 
it with a sheet. Roll lengthwise. Place it on the bed, unroll toward the 
patient, tucking it carefully under him, when, with very little trouble, 
it can be reached from the opposite side, and the bed thus covered. Then 
roll two blankets lengthwise, putting one on either side under the 
rubber sheet. A pillow now placed at the head and foot, under the 
rubber, will form a very serviceable bath tub. After the patient has had 
friction applied as per direction above, wet a sheet in tepid water, wring- 
fairly dry, and wrap the patient from his neck to his feet, keeping the 
hands under the cover. The cold compress is already on the head. Take 
an ordinary whisk broom and a large bowl of water, first without ice, 
then gradually adding ice till the bath is finished. Dip the whisk broom 
in the water and quickly sprinkle the patient from head to foot. Continue 
this from ten to fifteen minutes, according to the physician's direction, 
absorb the water with a large sponge or bath towel, remove the wet linen 
and rubber sheet quickly, but gently, and wrap the patient in a soft blanket. 
Take the temperature a half hour later and you will usually find that 
it has dropped from one-half to a whole degree. A little experience with 



BATHS. 253 

this bath and it will do very well instead of an ice water tub in typhoid 
cases. 

An evaporation bath is given by sponging the patient with tepid 
water, leaving the body moist, and gently fanning till the moisture 
evaporates. Repeat for fifteen or twenty minutes. Care should be exer- 
cised to prevent a draught reaching the patient when he is uncovered. 
This can be accomplished by improvised screens. 

In sponging, a piece of gauze or bleached cheese cloth is preferable to 
a sponge. The gauze can be shaken a few times and gets very cool. This 
laid on the patient for a moment, shaken again and repeated, serves 
to cool the skin, and feels very grateful. 

An alcohol sponge is given by exposing but small portions of the 
patient at a time, giving friction to the exposed parts until the blood 
circulates freely, then sponging with alcohol and water, equal parts. 
Pure alcohol should not be used for bathing, as it acts as an astringent 
on the pores. If alcohol is not at hand, a teaspoonful of salt to a quart 
of water will serve as a very good substitute. 

Vapor baths are sometimes desired in the home where there is no 
bath cabinet. A simple and convenient way to arrange one is by running 
a tape or string along the edge of a bed blanket, and gathering it about 
the patient's neck. Place a basin of hot water under a chair, seat the 
patient, protecting his feet and legs from danger of being scalded. Draw 
the blanket around the chair. Have ready a few, pieces of brick or small 
stones, which should be placed in the fire until very hot. Drop them, 
one at a time, into the basin. Keep the steam inside the blanket, and a 
profuse perspiration will soon take place. In cases of severe colds, 
grip, or asthma a tablespoonful of tincture of benzoate added to the water 
will prove beneficial. Much care should be taken that the patient does 
not take ccld after a vapor bath. Roll him in a dry blanket and cover 
well, letting him cool gradually. 

An improvised Sitz bath can be arranged by the use of a small 
washtub in the absence of a Sitz bath tub. Fill the tub one-third full of 
water, about warm enough for a bath. Have the patient sit in the tub 
with feet on the floor, using a folded bath towel to protect his back from 
the edge of the tub. Pour into the tub warmer water gradually till the 
bath gets hot as he can endure, having sufficient water to cover the hips. 
This bath is valuable in sciatica, kidney, and bladder troubles. 

Cold sponge bathing, in the absence of an opportunity to take a 
cold plunge in the morning, is most valuable to every one. It helps to 



254 MODERN NURSING. 

ward off colds, reduces susceptibility of tonsilitis from draughts, and 
refreshes the bather at the same time. A cold sponge and a brisk rub 
down immediately upon rising in the morning starts the blood bounding 
through the veins and helps keep the doctor farther away. 



CLEANLINESS. 

Much care should be given to cleanliness in and about the sick room. 
That uncleanliness is sure to spread contagion has been proven times 
without number. Where due care has been exercised, even virulent 
infectious diseases have been confined to a single member of a house- 
hold. On the other hand, where soiled linen and clothing have been 
allowed to stand without disinfecting, where cleanliness of the patient 
and the nurse, or those in charge, has been neglected, whole families, and 
even communities, have had to suffer with such diseases as typhoid and 
diphtheria. 

One nursing or caring for the sick should bathe frequently. He owes 
it to his own health, and also to the sensitive feelings of the patient. 
People will no longer tolerate the "Sairy Gamp" nursing of Charles 
Dickens's creation. A nurse should be dressed plainly, preferably in 
some wash material, hair kept nicely in order, hands and nails immacu- 
lately clean. This condition will act as a tonic to a patient, while an 
untidy, unkempt person will be so disgusting that the mere presence will 
act as a check to all good agents. It behooves the nurse, then, to first 
look after her own person. 

Many patients will think that they are too ill to be bathed. This, 
however, is simply an erratic idea. Every morning and evening the face 
and hands at least should be carefully bathed, the mouth and teeth care- 
fully cleaned, and the hair brushed. Even in cases of unconsciousness, 
there can be no excuse for not bathing the patient. It is refreshing, beside 
being necessary to the health. 

We would earnestly impress upon the nurse the importance of the 
care of the teeth, tongue, and roof of the mouth of fever patients. Unless 
carefully watched and frequently cleaned they will become filled with 
sordes, hardening, cracking, giving the patient no end of annoyance, 
and the breath a foul odor. Have the patient rinse the mouth well with 
boracic acid solution, or a mild salt solution. Do not use soda, as it 
dries the membrane, and will cause the tongue and lips to crack. With 



CLEANLINESS. 255 

a piece of gauze the mouth can be freed from all impurities, and the grate- 
fulness of the patient alone will be sufficient reward. Oil the lips with 
cocoa butter or cold cream. 

The nose of fever cases, especially typhoid and pneumonia, should be 
carefully watched, as the excretions become hardened and soon obstruct 
the nasal passages. When necessary, the nostrils should be oiled with a 
bit of olive oil. Do not allow the patient to pick at his nose, as a per- 
forated septum, or even worse results, may follow. A thoughtful nurse 
will watch out for all these little things, which amount to much in the long 
run. It is in just these minor details that the trained nurse proves valu- 
able, and those who have had no training cannot afford to ignore 
them. 

Always keep things free from dust in the sick room. This can best 
be done by going over everything lightly with a cloth dampened with a 
weak carbolic solution, or some other disinfectant. The dust should be 
removed at least once a day, as it will do much to prevent the dangers 
from disease germs floating about the house. 

All bed clothes, including the patient's bed robe, towels, etc., in con- 
tagious or infectious diseases, should be immersed in a carbolic solution. 
This will not injure nor stain the linen, and is a good germicide. They 
can be put in a boiler and quickly heated to the boiling point, but under 
no circumstances should they be allowed to stand without thorough dis- 
infecting. (For other modes of disinfecting see page 164.) 

In typhoid the bed utensils must each time be thoroughly cleansed 
and disinfected, for, be it remembered, that it is from the urine and stools 
that the disease is spread. Watch the bed linens carefully, and allow no 
spots to remain after the urinal or bedpan has been used. If small 
stains are found they can be disinfected with a solution of bichloride, 
without removing. Always bathe the hands of the patient after the 
bowels or kidneys have acted. 

To purify the air in the sick room, joss sticks, ground cloves dropped 
on a heated shovel or stove cover, or burned coffee, will prove agreeable. 
The better way to change the air is to close the sick room door, open 
the windows in the adjoining room for a few minutes, close them and 
open the doors of the sick room again, when pure, fresh air will take 
the place of the foul. Chloride of lime used in sick room utensils will aid 
in preventing the spread of the disease. Plenty of boiling hot water is 
another good agent. 

Vapo-cresoline, burned in the halls or at the entrance of a sick room, 



256 MODERN NURSING. 

is an aid in keeping the disease confined to one room. In cases of 
diphtheria, it is well to vaporize formalin or formaldehyde, in the kitchen 
and other living rooms after the family has retired. 

All sinks, drains, closets, and lavatories should be kept scrupulously 
clean and disinfected. The nurse owes it to her own health, as well as 
to others, that no detail be overlooked where care and cleanliness are con- 
cerned. 

APPLICATIONS OF HEAT AND COLD. 

The use of hot and cold applications in relieving pain dates back as 
far as history can take us. Their many uses, or therapeutic values, were 
then little realized, and it is practically only a few years since an intelli- 
gent use of these important agents was reduced to a science. Formerly all 
pains, inflammations, and congestions were treated with a hot pack, 
regardless of cause, location, or consequence. Hot applications to the 
head to cool a fevered brain, hot applications to the chest to reduce con- 
gestion in pneumonia ; in fact it was thought anything cold meant death 
to the patient. It is only a few years that typhoid patients, burning with 
fever and dying with thirst, have been allowed ice and cold water, the 
one great factor used to-day for their recovery. 

It stands to reason that cold, sensibly applied, will tend to reduce 
temperature, prove more grateful to the patient, and gain the end desired, 
where heat would but aggravate the disease. The question is when and 
where to apply heat, and when and where to apply cold. Should they 
both be applied at the same time ? Common sense and a scientific knowl- 
edge of their effect will help us to decide. 

First, in applying both heat and cold to the body, rubber water bottles 
are indispensable. They keep the bed and patient dry, and hold the heat 
or cold longer than the pack, and are in every way to be preferred, except 
where some medicinal agent, as turpentine, mustard, or ginger, is desired 
to act as a counter-irritant. 

In cases of injury to the head or spine, a bottle of ice water placed 
against the back of the head and neck will tend to reduce delirium, or 
brain fever. At the same time use a hot water bottle at the feet; also 
for the hands, if they are cold. 

In an attack of appendicitis, or any inflammation of the bowels, cold 
applications are to be preferred. They will allay the pain, reduce the 
temperature, and quiet the patient. An ice water coil is the proper 



HOT AND COLD APPLICATIONS. 257 

apparatus for applying cold to the abdomen, it being light, and the con- 
stant stream of ice water running through keeps it cool. 

In pneumonia, where the physician desires cold applications to the 
lungs, it is not usually convenient to apply an ice jacket in the average 
home. Several water bottles half filled with ice water and frequently 
changed, if packed around the patient's chest, will do very well. When 
hot packs are ordered, or desired, the same mode of treatment may be 
followed with the use of hot water, eA*ery care being exercised to prevent 
burning the patient. 

When hot packs or fomentations are ordered old flannels folded into 
large squares are to be preferred. By sewing the ends together and in- 
serting a stick at each end they can be wrung out very hot, without injury 
to the hands. One surface should be cooled before applying to the patient. 
Abdominal packs are frequently used to reduce gases, etc. When the 
patient seems excited and nervous from the hot applications, a cold water 
bottle on the back of the neck, or a cloth wrung out in ice water placed 
on the forehead, proves soothing and quieting". 

Poultices should always be applied warm or hot, as the chief object 
in using them is to hasten the decomposition of the tissue. 

Extremely hot baths in cases of languor, fatigue, depression, or a 
general aching of the body will prove a great relief. Fill the bath with 
water as warm as one can get into, then allow the hot water to continue 
running in till the bath is as hot as the patient can stand. A few ounces 
of sea salt added to this bath will increase its value. A brisk rub down 
with a coarse towel, and a good night's rest, will often prevent a serious 
illness. 

People in general do not use enough hot and cold water, either inter- 
nally or externally. A large quantity should be drunk every day to 
increase the sewerage of the system, and copious quantities used in bath- 
ing to keep the sewer gates open and the body in a healthy condition. 

FEVER NURSING. 

Probably the most important division of nursing is fever nursing. 
It is then, if ever, the patient's life depends on the eternal vigilance of the 
nurse, and it is then that the nurse from the first owes herself proper 
food, rest, and exercise in order to endure the fatigues which naturally 
attend a long illness. Self-sacrifice is not always unselfishness. The 
nurse who best cares for her own health takes best care of her patient. 



258 MODERN NURSING. 

Fevers do not necessarily mean high temperatures. People may run 
high temperatures and still not have a fever. A sudden chill, a slight cold, 
or an attack of indigestion may send the mercury up two or three degrees, 
but, if it is nothing more serious, a second reading of the thermometer a 
few hours later will find the temperature fallen back nearly to normal 
condition. 

In fevers the temperature goes up and goes down again, but is sure to 
rise, probably a little higher each time during a certain period. For 
instance, typhoid fever is caused by the poisons produced by colonies 
of microscopic germs in the bowels, which, strange as it may seem, live 
their lives in a series of sevens. This is called an "expectant fever," it 
being expected that the germs will have spent their force in fourteen, 
twenty-one, or twenty-eight days. This fever does not usually run more 
than four weeks, unless the patient becomes reinfected, and a new colony 
of germs begins work. The old idea of "breaking up" typhoid fever has 
long since exploded. Now, where we feel confident we have a case of real 
typhoid we settle down to work, hoping for the crisis in fourteen or 
twenty-one days, and in the meantime bending our energies to keep the 
unnatural fire from consuming the patient, by natural and artificial 
means of feeding it, and radiating the heat by means of baths, etc. 

In cases of this nature, where trained service is not available, it is 
of vital importance to make the next best choice, by selecting one whose 
personality will adapt him to the work, and to this one give right of 
precedence. In order to make a success in the sick room one must have 
a kind nature, at the same time be firm and decisive where necessity 
demands. One should be ready to obey the physician's orders implicitly, 
no matter what theory or reason he or she may have in regard to the 
matter, assuming from the beginning that the physician worthy of your 
employment has a superior knowledge in all matters pertaining to the 
disease and its treatment. There can be no liberties safely taken in 
fever nursing. It is far better to unflinchingly carry out the orders as 
nearly as possible in the manner prescribed. 

It is in these cases that the chart, baths, etc., already described, play 
an important part. Accurate, intelligent reports enlighten the physician 
as to the true condition of the patient ; they are the index to complications 
which are almost sure to arise in one form or another. 

Continued or expectant fevers are usually attended with more or 
less delirium, especially when attended by high temperatures, or the 
patient is of a nervous nature. In these cases there is usually low mut- 



FEVER PATIENTS. 259 

terings when the patient is in a restless sleep, and on waking they fancy 
they see people or objects which greatly excite them. It is better never to 
leave patients in this condition alone, even for a moment, as they may leave 
the bed, jump from the window, or do themselves serious injury almost in 
an instant. It is better to agree with them, even see things with them 
at times, soothe them by bathing the forehead, and gain their confidence 
in every way. This will soon dispel all fears, and your very presence 
will drive all disturbing visions from the bewildered brain. 

It is vastly important that the patient be fed. but the diet will doubt- 
less be milk, or some prepared liquid food, for many days. Until the 
crisis the patient will be satisfied with this restricted diet, but once the 
temperature drops and the fever turns, the craving for food is usually so 
great as to make the patient's appeals almost heart rending. Xow is the 
time when gentleness must be combined with unquestionable firmness. 
Five to seven days must usually elapse before the first morsel of solid food 
can safely be taken, and then in such insufficient quantity at first as to 
be only aggravating to the starving convalescent. However, to dis- 
obey the physician now will likely undo the good work already done, 
and most undoubtedly cause the death of the patient. It is better to 
withstand the pathetic appeals than to let your tender heart be touched 
to the extent of yielding. Practically, the most important part is played 
after the fever has abated. 

During a continued fever many complications are likely to arise, 
among them hyperstatic pneumonia, which comes from lying in one 
position too long ; pleurisy, caused by a slight cold, indigestion, or it may 
arise from lameness of chest caused by patient raising himself in bed. 
Hiccough is one of the worst complications, and fortunately does not 
frequently occur. Of course, in typhoid there is always danger from 
perforation of the intestines and from peritonitis. 

Much attention should be given to the condition of the bowels. 
Xurses are indirectly responsible for much of the trouble caused by the 
inaction of a patient's bowels and kidneys. That they move freely is of 
grave importance, and if they are allowed to become constipated and 
inactive, the great sewer through which the substance of the poisonous 
matter must pass be clogged, there will be no end of trouble : a rise in 
temperature, a toxaemia from intestinal absorption, and a greater liability 
to perforation. Such conditions should be reported to the physician, who 
will look to the matter at once. A careful watch should be kept of the 
stools to see if the food is being properly assimilated. 



2<5o MODERN NURSING. 

The importance of cooling" baths is in every way evident. By proper 
friction to bring the overheat; 1 blood bounding to the surface and cold 
water applied to cool the surface, it can be readily seen that the intensity 
of the fire will be reduced for a time. Hence, as has elsewhere been 
urged, baths cannot be too faithfully given. 

In the lesser fevers much the same line of nursing and attention is 
necessary. A frequent change of well-aired linen, thorough cleanliness 
about the patient and the house, systematic methods of "doing things" 
for the patient, all play an important part. 

In all cases of severe illness, rest and quiet are absolutely necessary. 
A fever patient is in no condition to receive visitors ; even the members of 
the family, not strictly obliged to assist in giving necessary care, should 
be excluded from the sick room for the patient's good. Where there is 
no trained nurse in the house this rule is likely to be overlooked, but in 
every case should be rigidly enforced. 

General principles, only, can be laid down for general nursing, since 
cases and circumstances will not admit of fixed rules. Helpful sug- 
gestions — suggestions born of a long and varied experience — can only 
be offered, and the rest is left to the thoughtfulness and intelligent obser- 
vation of whoever undertakes this most important work, whether from 
force, duty, or love. With the appearance of new symptoms we must 
look for complications. Quick wit. keen observation, and experi- 
ence will do much to check many of them before they get settled. 

For instance, common sense will teach us that to prevent hyperstatic 
pneumonia a patient should be occasionally turned in bed so that he does 
not rest continuously on his back or either side. That every caution should 
be used to prevent a patient from taking a direct draught, and in case of 
pleurisy that absolute quiet is necessary. If pains are extremely severe 
bind the chest tightly with a towel or laced jacket, which will diminish 
the chest action and reduce the pain. 

Thus will one need to be ready for any emergency. To be cool, col- 
lected, resourceful, is primarily essential to every one entering a sick room. 
Nervous, irritable, helpless attendants are worse than useless and should 
keep within their proper sphere. 

SURGICAL NURSING. 

It seems practically unnecessary to say much on the subject of sur- 
gical nursing. Most cases of major importance will be taken to the 



SURGICAL NURSING. 261 

hospital, or a proficient, trained nurse will be necessary if the operation is 
done at home. Minor cases, however, may be treated in the home, and 
a general idea of what to do and what not to do may prove of value. 

Since all disease is based on a germ theory and all cures on an elimi- 
nation of the cause, we must then admit it is necessary to destroy all 
germs or prevent them from coming in contact with clean wounds. A 
surgically clean wound will heal by primary intention; but should disease 
germs enter we shall find that complications will soon arise in the form of 
pus, decomposition or gangrene, and blood poisoning. Hence, the im- 
portance of keeping all cuts, bruises, etc., from infection. A simple cut 
or bruise on the finger is practically in more clanger from infection than 
the wound from the amputation of an arm or leg simply because less 
precaution is taken. We have seen most serious cases of blood poisoning 
from a simple bruise of a finger nail, which was thought to be of too little 
consequence to have proper treatment. 

In cases of cuts and bruises be sure that the basin or bowl in which 
the part is to be bathed has been thoroughly scalded with boiling water. 
For bathing wounds use only w^ater that has been boiled, to which has 
been added a ^mall quantity of carbolic acid, creolin, or some other 
germicide. In case there is no germicide at hand a spoonful of salt 
will answer very well. Only clean bandages that have been baked or 
soaked in an antiseptic solution should be used as dressing. People often 
remark that severe wounds are sometimes dressed with soiled hand- 
kerchiefs or other linen and do not become infected. True, they do not 
always become infected. Nature provides an antiseptic fluid in the 
blood, which goes a long ways to exclude germs. But surgical cleanli- 
ness, so far as is possible, is always advised. 

In case of important surgical dressings, of course, a surgeon will 
do the work, or directly supervise it. In cases of accidents or emergen- 
cies it simply remains for those at hand to see that due caution is used 
to prevent infection before the surgeon arrives. (For Accidents, etc., 
see page 571.) 

CARE OF CHILDREN. 

It is a lamentable fact that small children do not always receive the 
careful attention in sickness that their elders demand. Because a child 
is young and unable to talk or make itself understood there is all the 
more reason that the mother, or those into whose care the infant falls, 
should make a study to discern its wants and requirements. 



262 MODERN NURSING. 

We believe that most small children suffer from thirst and especially 
when they are ill. How can one who is nursing a child which is run- 
ning a temperature or burning with fever so far forget the delightful 
sensation of cool drinks as to fail to give the little sufferer a spoonful 
of water every now and then? Will it not prove as refreshing to the 
tiny mortal as to a man? And again we have often found that no 
thought is given to quiet for the sick baby. Doors are allowed to bang, 
the family bustle about and talk in loud voices, when if the little face 
be watched shadows of pain will be seen to pass over it with every 
sound. Yet, it can make no intelligent outcry against it. 

Babies need quiet, careful, thoughtful nursing even more than an 
adult. They need liquids in small quantities, but frequently. Their 
tiny brain needs the consideration that older people demand, and it is 
our duty to see that they have it. 

At the time children are teething they are usually fretful and peev- 
ish. The little gums are swollen, the stomach gets bad, and the child 
is ill. Many times convulsions occur at this period. In that case place 
the child in a very warm bath, chafe the hands and feet, massage the 
body quickly and roll in a warm blanket. A physician should be called 
at once, who may find it necessary to lance the child's gums, or, at least, 
will leave something for local application to alleviate the pain. When- 
ever the child gets fretful and tired a warm bath will be grateful and 
a refreshing sleep will naturally follow. 

If all babies and small children should be given a general massage 
at bedtime there would be less sickness, fewer pale, weak ones, and a 
marked decrease in the number of deformed boys and girls in the world. 
Ten or fifteen minutes given to the little one at bedtime is time valuably 
spent, for it will give health, strength, and a fine physique to the child 
and prevent many of the petty illnesses. 

Many mothers keep babies in a room that is too warm, or covered so 
heavily that the tiny creatures cannot move. This should be avoided as 
it will be likely to deform the little limbs, cause curvature of spine and 
general weakness. Place two or three water bottles partly filled with 
warm water about the child and cover lightly and give the little one 
fresh air. 

VISITORS, FLOWERS, ETC. 

One of the worst features of home nursing is the lack of discipline 
in the sick room. Patients are allowed to talk at night, often spending 



VISITORS AND FLOWERS. 263 

the entire night in sleeplessness, and then sleeping nearly all day. 
Have it understood that the night is designed for rest, not only for 
sick people but also for the other members of the household, and that it is 
a duty we owe to the family to be as quiet as possible. This will soon 
have its effect, and, save on rare occasions, there will be no more 
trouble in this direction. 

Another thoughtlessness on the part of those intrusted with home 
nursing is allowing visitors in the sick room. A patient will strive to 
be gracious and cheerful, appreciating the good intention of the caller, 
while at the same time his nerves are keyed up to a high pitch and there 
must necessarily be a reaction. Probably a sleepless night will follow, a 
depression of spirits and a rise in temperature, all of which will cause 
uneasiness. It is far better to exclude every one from the sick room 
save those in attendance. 

A careful nurse will not ply a patient with a multitude of questions 
nor allow him to carry on long conversations. All these things are a 
mighty help toward the desired end and cannot well be overlooked. Do 
not ask a patient if he will have this or that thing done. If it is the 
proper thing to do go at it without troubling him. It is a matter of 
business and should be treated as such. Do not encourage a patient in 
wanting constant attention. There is quite as much danger from over- 
doing as there is from doing too little. Sick people need rest and 
quiet. They are Nature's great restorers. 

Flowers should not stand in a sick room. Roses, violets, and lilies 
all have a heavy odor, which soon becomes nauseating. Flowers are 
beautiful and very few patients are unable to appreciate the sight of 
them. When flowers are sent by anxious friends they should be taken 
to the patient for a few minutes, if his condition will admit, otherwise 
even the knowledge of their having been received should remain a secret 
with the cards or names of callers, until convalescence is established, 
when the joy of knowing that friends have been thoughtful will be 
sufficient and no risks taken. It is always better to conceal things from 
patients that cannot benefit them. What they do not know cannot 
harm them and to keep them posted on trivial matters gives them 
material for anxiety and unnecessary concern. 

WHAT NOT TO DO IN THE SICK ROOM. 

Do not revolutionize conventional customs in a moment. Make 
changes gradually without annoyance to the patient. 



264 MODERN NURSING. 

Do not annoy the patient with useless questions nor carry on long 
conversations. Keep the sick room quiet and restful. 

Do not allow visitors or other disturbing influences to enter the 
sick room. Keep out all news of exciting nature, business matters, or 
anything likely to worry or annoy the patient. 

Do not allow soiled towels, glasses, or other utensils to remain in a 
sick room. 

Do not neglect to bathe the patient every morning and evening. 

Do not get excited in emergency cases. Be calm and collected and 
use your knowledge to good advantage. 

Do not give alcoholic stimulants to people with bleeding wounds or 
hemorrhages. Alcohol causes an increase in muscular action of the 
heart and consequently a greater flow of blood. 

Do not lose your dignity or temper before a patient. Be pleasant 
and forceful, sympathetic, but unflinching in duty. It is the only way 
to be successful. 

Do not try to deceive the patient or the physician. You will but 
deceive yourself and lose the confidence of both. Be willing to admit 
a fault or a mistake and do your best to make amends for it. 

Do not sing, whistle, hum, chew gum, rock your chair, or rattle the 
pages of a book or paper. Sick people's nerves are sensitive, and, 
though they may try to bear it rather than object, it is very trying and 
exhausting. 

Do not make the patient feel under obligation to you, yet at the 
same time do not let him get the idea you are his slave. Friendly rela- 
tions will prove a great help in the work. 

Do not neglect little things. Details count in long illnesses. 

Do not bustle in and out of the room more times than necessary. 
Make every step count. 

Do not always sit in the room or watch the patient unless he is 
delirious or for other reasons requires constant watching. It makes 
most patients nervous to be watched like a convict. Sit just outside 
where a low call or a slight movement will attract you. 

Do not neglect your own meals, rest, and recreation. Remember 
the best nurse is the one who takes best care of herself and thus fits 
herself to give best care to a patient. 

Do not think a little knowledge of nursing sufficient. Study and 
become competent to do the work well 



CONVALESCENCE. 265 

CONVALESCENCE. 

Most people do not realize the necessity of a complete recuperation 
from even a light sickness. The convalescence period should be watched 
and the patient carefully nursed and nourished that no serious complica- 
tions may arise and the result be impaired health for life or an un- 
timely grave. 

Convalescents are generally weak and emaciated, with ambition far 
exceeding their strength and judgment. Such should be carefully 
curbed in their desires and an ever watchful eye kept on them to be 
sure they do not take undue advantage during the absence of the 
attendant. 

Xow is the season when a careful, nourishing diet becomes a study. 
The stomach must not be overloaded, nor filled with indigestible foods, 
for it must be remembered the whole system is weak and cannot be over- 
worked. Small quantities served regularly and daintily, pure, fresh 
milk, carefully selected fruits will soon bring back strength and color. 

Bathing should not now be neglected. A tepid bath and brisk rub 
with a turkish bath towel, every morning, will freshen the skin and send 
the blood bounding along for the day. And this is the time when 
massage plays an important part. A thorough, scientific treatment be- 
fore retiring for the night will rejuvenate the nervous system, enliven 
the muscles, rest the patient, and give the entire body exercise which it 
so much needs and which at this time it can get in no other way. 

If the weather permits, a ride or walk in the open air and sunshine 
is of inestimable value. Let Nature do all she can toward the restora- 
tion of health. The trees and flowers, the hills and streams, present 
views which are a tonic for the heart and mind, and the fresh air, the 
smell of the earth, and the glow of nature give new hopes, new 
ambitions, and desires to get well. 

Do not let the convalescent get overtired. It is such a relief to 
leave the bed he often wishes to sit up too long at first. This should 
not be allowed. It is better to rest for a while than to tire the nerves 
and muscles, and risk a relapse. Again, be careful of draughts. Do 
not allow the patient to sit before an open window with a door or an- 
other window ajar in the room. Give him all the sunshine possible and 
make his surroundings so cheerful that he does not become depressed. 
Visitors may now prove their good will, few being admitted at first, 
and at no time a regular reception to be given. Use tact, judgment, 



266 MODERN NURSING. 

and common sense now as during the illness. Do not think the dan- 
ger is all past till the recovery is complete. A thorough and proper 
convalescence is slow. To hurry it beyond reason is to undermine the 
health, and nothing will be gained. Make haste slowly. An extra 
week or two in which to recuperate may mean a long life of happiness, 
while injudicious treatment may mean impaired health and years of 
misery. 

MASSAGE. 

Introduction. — That there is an unjust prejudice against massage 
and those who practise it is realized and lamented by all legitimate 
masseurs. That the treatment has been abused and the profession 
scandalized by unscrupulous impostors must be admitted, but it does not 
lessen the value of the treatment. All professions have quacks, who, 
for a time, injure those who do an honest business, but in the end they 
are themselves the injured. That massage is used the world over in 
the treatment of disease and to preserve physical health should be 
sufficient indorsement. The world's best physicians and surgeons rec- 
ognize in it a vast benefit to a large class of patients and are each year 
recommending it to greater numbers. 

It is only those who are ignorant of the treatment and its benefits 
that are ready to condemn it. Every one who has been confined to a 
sick bed remembers how comforted and rested he felt after having his 
aching back rubbed for a while, or how soothing and refreshing it was 
to have the feet and hands chafed when he felt tired and sleepless. 
That was a crude form of massage which proved an agreeable agent. 
How much more beneficial, then, would be a knowledge of how to do 
the work in a practical, scientific way ! 

Massage is a treatment whereby the muscles, nerves, and blood ves- 
sels are scientifically manipulated by the means of systematic rubbing, 
rolling, kneading, moulding, thumping, squeezing, slapping, and whip- 
ping until the body has received the necessary exercise and the blood 
is hastened along its course, thus rejuvenating the entire system. 

Space will not admit of a long discussion of its uses and abuses, nor 
is this article intended as a text-book on Massage. It is written with 
the idea of giving to the layman a fair idea of the treatment, that when 
professional service is not available he may be able to render practical 
service where it is required. 



SYSTEMS OF MASSAGE. 267 

Its Uses and Benefits. — As has already been stated, massage is bene- 
ficial in restoring and preserving health. Certain diseases require an 
enervating exercise which the patient's lack of strength will not permit. 
People, like lawyers, bookkeepers, stenographers, and others who lead 
sedentary lives and do not have time or energy to take proper exercise, 
require the treatment to keep themselves in good physical condition. 
For that tired, lifeless feeling, nervousness, sleeplessness, constipation, 
sciatica, contraction of cords and muscles, paralysis, stiff joints, and 
many other diseases and complications to which the flesh is heir, there 
is no greater or better remedy than thorough massage, given by one 
who is intelligently capable of administering the treatment. 

We cannot go into detail in describing the differences and similar- 
ities of different systems. A general description will suffice since they 
all tend to the one great end, exercise, rejuvenation, and development. 
The Swedish system is vigorous, bracing, and in its true form can be 
given only to strong, muscular, hardy people like athletes. It exer- 
cises the muscles to the bone, giving to the subject at each treatment the 
benefit of an eight mile walk without the fatigue. 

The German system is less vigorous and is usually given in connec- 
tion with baths. This treatment is suitable for the average patient who 
has not been reduced to a weakened condition by a long illness. This 
treatment can also be given to fracture cases with gratifying results 
after the bones have become firmly knitted together. Practically speak- 
ing, German treatment is a modification of the Swedish system, omit- 
ting Swedish movements and substituting the baths 

The French system is also called the Beauty treatment, and is a deli- 
cate manipulation, designed especially to keep the skin free from wrin- 
kles and blemishes. It is given mostly to the face, neck, arms, and hands, 
and is a wonderful developer and producer of beauty. The fact that 
so many Parisian ladies remain beautiful even to old age is greatly due 
to beauty treatment and the excellent care they give to the skin. French 
massage is not particularly beneficial to invalids, save as it gives a re- 
freshed feeling to the skin. 

When to Give Massage. — In giving massage treatment there are 
several things to be thought of and considered. First, the room should 
be warm and free from draughts. Second, the patient should be in a 
condition to receive the treatment. Owing to the tender condition of 
the bowels in typhoid it is extremely dangerous to give general massage. 
In case of a very weak heart the increase of circulation from vigorous 



268 MODERN NURSING. 

massage would be disastrous. Hence, it is necessary to have some 
practical knowledge of diseases or consult a physician. 

In case a subject perspires freely give a cooling sponge bath and 
use a little toilet powder. Do not massage a moist skin. Where the 
patient is covered with a heavy growth of hair, as on the arms and legs, 
it will be necessary to use extra precaution or repeated treatments will 
cause irritation at the roots and abscesses will form. Do not rub these 
parts in the opposite direction from which the hair grows. Do not 
massage over the breasts or navel (umbilicus), use a circular motion 
from left to right in these sections. Do not be afraid of getting too 
near the bone in deep muscles, nor use too much force over the bowels 
and vital organs. 

The old idea that in rubbing a patient one should always rub toward 
the end of the fingers and toes is quite wrong. The fact that the veins 
lie near the surface and carry impure blood back to the heart and thence 
to the lungs to be freed from its impurities, is sufficient reason for rub- 
bing or massaging toward the heart, thus hastening it back with all its 
poisonous load. Hence, in giving massage treatment, always work to- 
ward the heart in circular movements from left to right. 

To produce or induce sleep begin with the head, then massage the 
arms, the body, the legs, and finish with the feet. This brings the last 
great rush of blood away from the head and leaves the brain cool and 
quiet. Downward strokes in massage, as in hypnotism, have a sleep- 
producing effect, while upward strokes, bringing the rush of blood to 
the head, have the effect of making the patient wakeful. 

Massage should not be given immediately after a hearty meal nor 
on an empty stomach. It is better to wait at least an hour after a full 
meal, and if massage is given in the morning it is better that the patient 
take a glass of milk, an eggnog, or something light before the treat- 
ment is given. Usually the patient will wish to remain quiet for half 
an hour or so after having massage. This is to be encouraged as it les- 
sens the danger of contracting cold and the subject will feel more re- 
freshed for the rest. Expose only the part being treated and cover this 
surface before beginning a new section. 

We do not advise the use of creams or so-called skin foods in the 
general treatment. Oils grease the surface, prevent the friction and 
transmission of vitality of the masseur, clog the pores, and are use- 
less save in cases where they are advised by physicians for throat and 
pulmonary troubles. Then the part should be first thoroughly treated 



HOW TO MASSAGE. 269 

without the oil, which may later be applied and massaged in. A clean, 
fresh skin treated with the clean, bare hand of the operator will prove of 
greater benefit than any applications. 

The question is often asked. "Is it necessary to expose the body? 
Cannot the treatment be successfully given through thin clothing?'' 
To this we would say that treatment can be given with value to the 
subject through clothing, but the mere fact that the hand of a strong, 
robust, healthy manipulator transmits more or less of his vital energy 
is sufficient reason that clothing should be discarded. It is never nec- 
essary to expose a patient enough so that the most sensitive need object 
to the treatment from a first-class masseur. But. if one is to have 
treatment through clothing or a blanket, why not resort to purely 
mechanical massage? Some masseurs with an enviable reputation re- 
fuse to give treatment with the bare hand, claiming too great a loss of 
vitality through transmission by contact. Such operators wear rubber 
gloves. 

Importance of a System. — From the foregoing statements of facts 
it will be readily seen that it is essential that there be a system for giv- 
ing massage treatment if one would have beneficial results. It has been 
our experience that no one system will apply to all cases ; that it is 
necessary to modify any system or perhaps combine the several as the 
case at different stages demands. We would not give to a patient, 
emaciated and weak from a fever or long illness, a vigorous Swedish 
treatment at the beginning of his convalescence. Such a treatment to 
a well, strong man, if he were not accustomed to massage, would bruise 
his muscles and make him so lame and sore that he would think he was 
the victim of a prize fight. On the other hand a gentle, easy treatment 
would be of no great benefit to a football player or athlete. One must 
exercise reason in the case. Begin lightly with delicate cases, increase 
the pressure from day to day until the muscles become accustomed to the 
treatment. Later, as the muscles become hardened, rounded, and full, 
it will require a great deal of strength to give a treatment that will be 
beneficial or satisfactory to the subject. 

Always begin the treatment in the same manner and take each manip- 
ulation in its turn. A raised couch or table, narrow enough to enable 
one to work handily from either side and high enough to relieve strain 
from the operator, is necessary. Have patient lie fiat on the back with 
muscles all relaxed. In treating the abdomen have patient draw knees 
up as it relaxes the abdominal muscles. When one side has been treated 



*70 MODERN NURSING. 

the patient will lie face downward while the muscles of the back and 
buttocks receive treatment. 

How to Give a Massage. — Beginning with the head, rub the scalp 
with the finger tips in a brisk, energetic manner to start circulation 
there. With a rotary motion massage the face, beginning with the chin 
and working upward and outward toward the ears, till a healthy glow 
appears. This is not intended for a beauty treatment and five minutes 
is sufficient for the head and neck. 

Next raise the arm and from the tips of the fingers stroke to the 
shoulder a few times, to start surface circulation and prevent chilliness. 
This should be done in exposing any part of the body. Beginning with 
the tips of the fingers rub each joint separately with a circular move- 
ment much as you would in putting on a new glove. Working toward 
the palm, massage each joint, following the palmar bones to the wrist. 
It is here that the long muscles and real work begins, (i) With the 
arm grasped with the two hands use the thumb side in a parting motion, 
as if the muscles were being divided or parted from the bone. This 
should be done the entire length of the arm, or in any long muscles. 
(2) Next, wring or twist the muscles much as you would wring a wet 
sheet, the hands acting in opposite directions. This movement drives 
the blood with force from the muscles and arouses the nerves to a keen 
sense of being. (3) Knead the muscles next, by placing one hand on 
the underside and with the ball of the thumb and a grasp of the hand 
roll the muscles with a slow rotary motion from left to right. This 
should be thoroughly done on every muscle, following the general 
direction of same. (4) Next, begin with the end of the fingers, with 
quick, firm grasp squeeze the muscles, hastening the blood on toward 
the heart. By this time the skin should be in a healthy, pink glow; if 
not repeat the treatment. Massage the elbow joint carefully, leaving 
no spot unexercised. To increase the glow and bring the blood to the 
surface whip with the fingers by giving them a quick, sharp shake, like 
the snapping of a whip, flaying the patient not too severely. On deeper 
or larger muscles this should be preceded by a hacking motion. Open 
the hand, extending the fingers, and use the outer side of both in a quick 
chopping or hacking motion. 

The shoulder and hip joints should receive careful attention, work- 
ing deeply, getting near and around the joint until it is thoroughly 
treated. 

In treating the chest lay the hand flat, giving greater weight to the 



HOW TO MASSAGE. 271 

thumb side; use a twisting motion from left to right, avoiding pres- 
sure over the nipples. Next, grasp the flesh between the thumb and 
index finger near the short ribs, and with a creeping movement roll the 
muscles upward. Repeat the treatment several times. A healthy red 
will usually quickly appear on the chest. 

To treat the abdomen have the patient draw the knees well up, re- 
laxing the muscles. Place the hands flat on the bowels near the hips, 
and with weight from the wrist roll the hands forward to the tips of 
the fingers. This must be done firmly and gently so as not to injure 
the patient. Continue the rotary motion here as in other sections. 
Work well over the liver on the right side. By a little experience the 
bowels can be most thoroughly and deeply treated without causing the 
patient annoyance, and with great benefit in cases of torpid liver, con- 
stipation, etc. 

Treat the legs in the same manner as the arms, using greater force 
in case of deeper muscles, and going over these parts several times with 
the same treatment. This is necessary on account of the greater depth 
of muscular tissue, larger blood vessels, etc. Large, deep muscles will 
stand a great deal of thumping with the fist, hacking, and slapping with 
the open palm. 

In treating the back, always begin with the back of the head and 
neck, massaging thoroughly at the base of the brain and along the 
spinal column. Here lie the nerve centers and it is necessary to give 
them a good stirring up, to put new life into them. Treat the back 
much as the chest is treated, rolling the muscles well between the thumb 
and finger, and with a circular motion. Flay the spine till it gets 
decidedly rosy. 

When the entire body has received treatment some simple Swedish 
movements will be beneficial and refreshing. Beginning with the hands 
rotate each finger from right to left four times, then in the opposite 
direction four times. Treat the wrist in the same manner, raise and 
straighten the forearm, the patient using a little resistance. Extend 
the arm, grasping the wrist and elbow. Move it in a large circle four 
times one way and reverse the order. The feet and legs may be treated 
in the same way. This makes a very satisfactory finish to the massage 
treatment and will prove very grateful to the patient. 

In treating special cases a general knowledge of massage is neces- 
sary. The better one understands anatomy and is able to follow the 
direction of the muscles, the better treatment he will be able to give. 



272 MODERN NURSING. 

Forty-five minutes is required for a general massage, and will usually 
be as long as the subject or masseur cares to put into a treatment. 

In giving local treatment follow general rules for that section of 
the body. In cases of localized fluid, synovitis, local inflammation, etc., 
massage away from localized point. In fracture cases do not massage 
directly over the fracture. Massage on both sides to increase circula- 
tion and nutrition, thus adding strength to the union. 

In cases where patient is confined to the bed and unable to be 
moved, a general, gentle treatment of all parts that can be conveniently 
reached will greatly rest the patient. Instead of "rubbing" a patient in 
the old fashioned way, treat him with genuine massage movements, 
which will prove more grateful and beneficial.. 

MASSAGE FOR SPRAINS, BRUISES, ETC. 

In case of sprains, as for example when the cords of the ankle are 
strained or lacerated, the condition will very soon become painful, 
swollen, and black. Ascertain if the bones are all in proper place; if so, 
raise the ankle high, and massage evenly and lightly the affected part 
for half an hour or more, rapidly driving the blood away from the spot 
where it will be likely to settle because of the torn condition of the 
capillary cells. By faithfully massaging the joint much of the cedema 
will be prevented and the pain will be reduced, Bathe the joint with a 
hot salt solution and bandage tightly. In massaging sprains use the 
circular motion with the ball of the thumb, the "parting" movement to 
increase venous circulation away from the joint, and the tips of the 
fingers directly over the affected part to encourage circulation through 
the injured cells. 

To prevent blood from settling in a bruise, massage thoroughly, 
driving the blood through the bruised part until a new circulation is 
established. Hot fomentations will assist in the removal of discolora- 
tion. After treating in this way, bind a thin piece of well pounded 
raw beef over the part for a few hours and there will be little annoy- 
ance from discoloration. The massaging should be done as soon as 
possible after injury, before the part gets sensitive to the touch. 

BEAUTY MASSAGE. 

It is safe to say that the majority of people do not enjoy the 
approach of old age and decay, and desire to prolong youthfulness in 



BEAUTY MASSAGE. 273 

every way as long as possible. Gray hairs are no longer considered 
a harbinger of old age nor do they usually detract from a person's 
comeliness. Wrinkles, a parched, withered, lifeless skin, flabbiness of 
the muscles, puffs under the eyes, sagging of the corners of the mouth 
and a general heaviness of the lower part of the face are the noticeable 
signs of years. Intemperate habits, late hours, worry, churlishness, 
and overwork encourage decay. Sluggishness, torpidity of the liver, 
and illness promote sagging of the muscles, sourness of expression, 
and general ugliness. 

If one would retain the youthful look, one must first consider the 
health and habits. Nature will do her part to make all things beautiful, 
and while old age when sweetly attained is the glory of a life, ugly 
wrinkles and blemishes are unsightly to everybody. Outside the 
savages, who delight in making themselves hideous, there is no man or 
woman of intelligence who does not wish to look well. One can be 
proud of his person and yet not vain. Artificial beauty through 
cosmetics and accessories may be vanity, but to preserve the youthful, 
healthful vigor of the skin, the delightful contour of the face, to 
eradicate the signs of dissipation, fretfulness, and severity, cannot be 
considered vanity. In order to do this one must have a purpose and 
this purpose an ideal; and since ideals usually lead to loftier sentiments 
and aspirations, the desire to retain the beauty of youth must be most 
highly commended. A haggard, seamed, distorted face is not only 
repulsive, but elicits little sympathy from the world. No matter how 
the heart may have been wrrtng to cause the unsightly furrows on the 
brow or about the eyes, the world is looking for beautiful and fresh 
faces and will not stop to inquire if the wrinkles have come from 
honorable old age, or have been cultivated by a life of dissipation, 
ribaldry, and unhappiness. 

True, the lack of happiness in certain classes produces premature 
signs of decay, even on the faces of innocent children. The more the 
pity, and the more the necessity of knowing how to cultivate beauty. 
Perfect health, cheerful surroundings, pure manhood or womanhood 
will keep the ravages of time at a long distance. This we all wish to 
do. 

In order to keep the skin fresh, the pores must be kept open and 
the face frequently bathed to free it from impurities. Hot water should 
rarely be applied. It is better to use a tepid bath, with some pure, 
carefully selected toilet soap, in moderate quantity, when the skin is 



274 MODERN NURSING. 

oily or necessity requires. Great care should be exercised in bathing 
and drying the face not to injure the epiderm or outer layer of skin, 
leaving it rough and scaly. Under exposure to the heat of the sun's 
rays, the rough winds and storms will injure this delicate skin unless 
it is carefully treated. People who live in a cool, dry climate have the 
best and most easily kept complexions. 

We do not recommend the general use of creams, skin foods, and 
cosmetics so much advertised. More or less of them are harmless and 
quite useless, while some are injurious. Purity of the skin by steam- 
ing and bathing is better than artificial means of opening and clogging 
the pores. Sometimes a cream may prove of value, as in the case of 
sunburn, dry or parched skin, blackheads that cannot be easily removed 
by steaming and bathing, etc., but generally, a clean, healthy skin will 
be its own scavenger. 

To aid in eradicating wrinkles, rejuvenating the features, develop- 
ing the muscles, assist in removing decomposed tissue and in hasten- 
ing the up-building of new, a light, firm, scientific massage will prove 
of immense value. In order to have it prove of greatest value it will 
be necessary to understand the reasons for the treatment. 

First, massage hastens circulation, and, since nutrition depends 
largely upon circulation, the building of new tissue is accelerated. 
Secondly, the manipulation of the muscles causes development, thus the 
parts most exercised will develop or fill in; hence the necessity of great 
care in massaging for eradication of displeasing features, such as wrinkles, 
double chin, suspended or flabby muscles, etc., not to increase them. 

The reason for massaging the face before wrinkles appear is clearly 

evident. To keep the skin fresh, the circulation perfect, the impurities 

removed, the muscles from sagging, and undesirable features from 

developing is reason sufficient. Anyone can keep the face fresh by 

giving it a few minutes of daily attention. It is always better for a 

second person to massage the face, since it is easier and possibly the 

results are more satisfactory, though this is not absolutely necessary. 

A good way to do where professional service is not available, is for 

one to massage another's face, and in return receive a treatment. This 

can be most successfully done where both parties are careful and 

interested. 

TO MASSAGE THE FACE. 

Seat the subject in a high back chair with the head thrown back 
and the face up-turned. Wring a napkin in very warm water and 



TO MASSAGE THE FACE. 275 

cover the face for a few minutes, repeating two or three times. Dry 
the face gently and the skin will he in a fresh, susceptible condition for 
good work. Stand at the back of the chair working from the lower 
part of the face always toward yourself. This will have a tendency to 
bring the muscles up, relieving the heavy look about the lower jaw. 
In massaging one's own face this should be borne in mind, that the 
stroke should be upward and outward toward the hair. 

Begin with the chin, and, with the tips of the fingers and a light 
gentle stroke, draw the muscles back and up over the ear. With the 
fourth finger (counting the thumb as the first finger) supported by the 
thumb, used as a brace, massage the wrinkle across the chin length- 
wise with a smooth, light, circular motion. All wrinkles should be 
massaged lengthwise instead of crosswise. Massage the lower lip in the 
same manner drawing the motion well up past the corners of the mouth. 

The entire face should be massaged with this same gliding circular 
movement, working the wrinkles of the forehead and about the eyes 
well out into the scalp. Massage the upper eyelid by carefully pinch- 
ing the entire surface to enliven the skin. If the eyes have rings or 
puffs beneath them do not massage the rings or puffs, but give special 
attention to the adjacent surface, getting up a free circulation away 
from the localized parts. 

To massage the long wrinkles extending each side of the nose, hold 
the muscles of the cheek back until the wrinkles are smooth and then 
massage the seam lengthwise. Give the eyebrows a treatment follow- 
ing the natural curve with a circular motion upward. 

In case the subject has a double chin this can be removed by draw- 
ing the fingers with slight pressure from the middle of the chin and 
throat outward and upward behind the ear. The exercise given for 
developing the neck will also greatly assist in removing a double chin. 
After finishing the treatment bathe the face gently and dry carefully. 

In case of hollow cheeks, sunken eyes, etc., a pinching of the 
muscles and drawing them out with the five fingers is beneficial. Suc- 
tion cups, which are recommended for this purpose, can also be had at 
a drug store. They are inexpensive glass cups with rubber bulbs and 
are excellent for developing a thin lower face. 

Place the cup firmly on the middle of the chin, when the edges will 
attach themselves to the skin. Work the cup upward and outward, then 
press the bulb and release the glass. Repeat several times. Make 
sure that hollow cheeks do not come from loss of teeth. This is a most 



276 MODERN NURSING. 

common cause of this unsightly feature. Have the space caused by the 
loss of teeth fitted with porcelain or other material and thus present 
the round contour. 

After using creams or skin foods, be sure they are thoroughly 
washed from the skin. Do not allow the pores to become clogged. Do 
not apply cream to a moist skin unless you would have an unsightly 
growth of hair on the face. Do not use yellow or red vaseline on the 
face as it leaves an ugly, yellow stain and is also drying to the skin. 
Do not use alum, tannin, or other astringents on the face if you would 
have a soft, delicate, fair complexion. 



HOW TO DEVELOP NECK AND CHEST. 

There is little excuse for having a long, slim, undeveloped neck if 
one will give it proper exercise and attention. The same might also 
be said of a short, fat neck, with an unsightly double chin. 

If the neck be too long, to develop it well at the base and fill it out 
at the shoulders and around the clavicle will tend to give the idea of 
shortening. This can be done by carefully and vigorously massaging 
the base, across the collar bone, and out to the shoulder, drawing the 
muscles well out of the hollows and rolling them between the thumb 
and finger. A suction cup or the five finger massage that is used on a 
hollow face will prove of great value. To assist in the development, 
inflate the lungs, elevating the chest and shoulders, throw the head back 
and roll it around the chest three or four times in one direction and 
reverse the order. This exercise is very beneficial and should be care- 
fully practised. In cases of large, short, and fat necks it will greatly 
reduce adipose tissue, make the muscles firm and compact, and assist in 
removing the double chin. 

To make a full, round, healthy chest, place the hands on the hips 
and inhale a full breath. Expel it gradually, whispering the syllable 
"huh." Again inhale and swing each arm in wide circle four times 
in one direction and reverse the order. Expel the breath forcibly after 
each exercise. Swing both arms as a final exercise. This, together 
with the massage treatment of the chest as given under general mas- 
sage, will develop a thin, hollow chest into a full, round, robust one, 
adding not only beauty but health to its possessor. 



BEAUTY MASSAGE. 277 

TO MAKE THE HANDS AND ARMS BEAUTIFUL. 

Nature does much toward giving every one symmetrical proportions, 
but through disease or lack of exercise, certain muscles are undeveloped, 
while muscles that are constantly worked are over-developed. This 
should be borne in mind in developing any part of the body. 

The first care of the hands is to keep them clean and the nails 
properly manicured. Grimy hands and badly kept nails are enough to 
spoil every other beautiful feature one may possess. The hands are an 
index to the inner man and their care speaks in glowing though silent 
words of his habits. 

Care of the skin must be regarded as the care of the face. The 
hands are subject to all sorts of hardships and it is not easy to keep the 
average hand always in good condition. By thorough bathing, using 
a soft brush and best grade of toilet soap, by the use of a cream or 
lotion to keep the hands from chapping or cracking where it is neces- 
sary, and daily giving them a little extra care, they need never be 
unsightly. 

To massage the hand and forearm for development and taper, place 
the elbow on a table with the hand elevated. Massage each finger 
separately, much after the fashion of working on a new glove. Con- 
tinue this to the wrist. 

Place the forearm between the two palms and rapidly roll the 
muscles working from the wrist to the elbow several times. This will 
round and taper the arm to the elbow. Treat the elbow to a thorough 
massage and roll the upper arm as you did the forearm. 

To massage one's own arm hold the hand in the same position and 
stroke the arm from the hand toward the elbow. This is not so satis- 
factory as the other method, yet in time will make a marked improve- 
ment and give it a graceful taper. Patience and time are required for 
all developments, but are sure to bring reward. 



FOOD FOR THE SICK. 
HOW TO PREPARE AND SERVE IT. 

Dietetics, or the science of diet and of its regulation, plays an 
important part in sickness and in health. It is the prime duty of all 
who care for the sick in whatever capacity to see that the patient 



278 MODERN NURSING. 

receives proper food, properly prepared and served in an appetizing 
way. It is equally important, if not more so, to see that no injurious 
or improperly prepared food is served to the patient. There are many 
who are actuated by the kindest motives in offering articles of food 
to an invalid when they are guided by their own likes rather than by 
any thought of whether it will be beneficial to the sufferer or whether 
his enfeebled digestive capacity can bear it. Others again commit 
dangerous and even fatal indiscretions by their inability to withstand 
a patient's pleading for food which is beyond his power to digest or to 
retain. It is after a crisis in a disease has been reached that especial 
care must be taken to proceed carefully in the matter of diet. During 
the period of extreme suffering there is usually little appetite or 
demand for food, but in early convalescence a craving for improper 
food sets in and sympathetic friends are very prone to satisfy the 
desires, with very serious consequences. 

Diet for the sick is often specified according to the article of food 
which prevails in or composes such a diet. Accordingly there is a Milk 
diet, a Meat diet, a Fish diet, a Vegetable diet, a Broth diet, a Mixed 
diet, a Liquid or Spoon diet. It is often specified by the amount of 
food to be given at a time. In this classification there is a Full diet, 
a Generous diet, a Common diet, a Subsistence diet, or one upon which 
a person can barely live, a Half diet, and a Low diet. 

There is another mode of designating a diet, which is by stating the 
particular disease or condition which it is intended to meet. 

A Fever diet is one made up of milk, broths, toast waters, and 
jellies. There is no solid food whatever, or vegetables, or fruits. 

A Gouty diet prohibits meats, wines, and beer. 

A Diabetic diet allows no sugars, starches, bread, rice, potatoes, 
fruits, or sweet wines. 

A Banting diet is designed to reduce flesh and does not permit the 
eating of fats, cream, starchy or sweet foods, sweet wines and stout or 
porter. 

A Convalescent diet is a light, easily digested, simple solid or liquid 
diet. 

A Subsistence diet, such as would be given in aneurism for instance, 
is composed of: Breakfast, two ounces of bread with butter and two 
ounces of milk; Dinner, two or three ounces of bread, two or three 
ounces of meat, and two to four ounces of milk or of claret wine; 
Supper, two ounces of bread with butter and two ounces of milk. 



SERVICE OF FOOD. 279 

It must not be forgotten that the original meaning of the term to 
nurse is "to nourish." In no way can the offices of a good attendant of 
the sick be so well directed as in the providing of nourishing food, well 
cooked, and served in an enticing, attractive way. While this attention 
always supplements the efforts of the physician, there are many cases in 
which it supersedes his attentions. Very often the good nourishment 
that a patient gets is of more benefit than the medicine which the doctor 
supplies. One of the most pathetic sights during illness, next to the 
sufferings of the patient, is the utter helplessness of loving friends and 
relatives, who are impelled by affection and sympathy to do something 
to minister to the needs and comfort of the sick one. They either sit by 
and do nothing or make pitiable, blundering attempts which only add 
to the discomfort. 

It is not so much what is done as how it is done that counts in the 
sick room. And- the art of waiting on the sick in an efficient way can 
be cultivated by anyone, to the degree of making one's attentions appre- 
ciated and helpful. 

Service of Food to the Sick. — Let the patient have a set of dishes for 
his exclusive use. This is imperative in cases of contagious diseases; 
but let it be so in every case. They should be the daintiest and most 
attractive that the china closet contains. It goes without saying that the 
napkin must be clean — provide a fresh one with every meal, if necessary. 
The china must be spotless, the silver polished, and the glass sparkling. 
When putting the food into the dishes, take care that cups and saucers 
are not so full that the contents will spill or slop over when carried. 
Not alone for that reason but also because the service of a large portion 
of food at a time not only does not attract a capricious appetite, but may 
lead to over-indulgence. A small service may lead the patient to ask 
for a second portion. There is also danger of large portions becoming 
cold during the slow eating of the patient. For it is important that food 
which is intended to be served hot, should really be hot; and that which 
is to be cold, must be so. The seasoning of the food is an important 
detail. Where the nurse knows the wishes of the patient in this respect 
it is easy to accord with it. Probably more salt will be desired than 
when in health, and less sugar. Pepper and high seasoning are not 
desirable. 

The freshness of food must be beyond all possible doubt. If eggs 
are served let them be broken out of the room, so that their purity may 
be unquestioned. The milk and cream must also be sweet, a point that 



280 MODERN NURSING. 

is liable to be overlooked in summer. If there is the slightest doubt 
about the condition or quality of an article of food do not serve it. The 
only safe guide for the condition of food when prepared is by tasting 
it; but don't under any condition do so in the presence of the patient. 
Do that in the kitchen so that anything necessary may be supplied before 
the patient sees it. 

In planning a meal for the patient, the first thing to do is to know 
very definitely and exactly what foods he can eat and what must not be 
given. Make yourself very thoroughly acquainted with the articles to 
be supplied. Have plenty on your list so that you will be able to supply 
a variety from time to time, to take advantage of the market, and to 
consult the patient's tastes. But don't consult the patient too freely 
about what he will or will not like. Especially don't do so just after 
he has partaken of food. None of us, even in health, care much about 
the next meal when we have just finished one. Besides, a little surprise 
in the way of something which he is known to like and does not expect 
will often prove most agreeable to him. Get a good list, either from 
the doctor or from the following pages, and then prepare and serve 
them in the most attractive manner possible. 

Time of Feeding. — See that the patient gets his food right on the 
minute. This is not only important in so far as the supply of food is 
concerned, but more especially to promote digestion. The stomach 
expects a certain amount of work at certain definite intervals, and, in 
cases of illness, this gives rise to feelings of discomfort if the intervals 
are not regular. Feeding at night is a matter to be decided by cir- 
cumstances. It is only in very exceptional cases that a patient is to 
be awakened to partake of food. If a glass of hot milk is given just 
before time for sleeping it will in many cases bring a sense of sleepi- 
ness and ward off possible insomnia. If a patient asks for food in the 
night he should get it, and it will be better if a supply is prepared, or 
partly so, in case of such emergencies. If too long time is taken the 
patient may get over the desire for it. But as it will naturally be of a 
very light and digestible nature it will not take much time to get it 
ready. 

Assistance to a Patient While Eating. — When a patient is help- 
less it will be necessary for the nurse to render all possible assistance 
while food is being taken. The head must be raised, and it is important 
to see that the head is not turned to either side. Even a very slight 
turn will be sufficient to cause the food to run out of the corner of the 



DIET FOR VARIOUS DISEASES. 281 

mouth. His clothing must be protected with a clean, fresh napkin or 
towel, lest the food be spilled upon it. If he is very weak he will 
better use a bent glass feeding tube, rather than attempt to drink from 
a glass. Much more food will probably be taken by this means, and 
the supply can be better regulated. Only small mouthfuls are to be 
given and care must be taken that all food is properly masticated before 
another mouthful is given. See that the mouth is properly cleansed 
after food, for when the food lodges in the corners of the mouth there 
is great danger of sores occurring. When the patient is feverish the 
thirst will be correspondingly great. In giving cooling drinks it is 
well to use a small glass filled with the liquid, rather than a larger 
glass only partly filled. There seems to be more in the smaller glass- 
ful, and the patient will generally be better satisfied with it. 
Diets for various diseases : — 

FEVERS. 

The patient may take : — 

Foods. — Soups, clear or thickened with some well cooked farinaceous 
substance, mutton, clam or chicken broth, beef tea, peptonized milk. 

Drinks. — Pure cold water, toast water, lemon or orange juice in cold 
water, cold whey, all in small quantities, sipped slowly. 

The patient must not take : — 

Any solid or vegetable food or fruit, until so directed by the physician 
in charge. 

DYSPEPSIA. 

The patient may take : — 

Soups. — Clear, thin soups of beef, mutton, or oysters. 

Fish. — Oysters raw, shad, cod, perch, bass, fresh mackerel. 

Meats. — Beef, mutton, chicken, lamb, tripe, tongue, calf's head, 
broiled chopped meat, sweetbread, game, tender steak. 

Eggs. — Boiled, poached, raw. 

Farinaceous. — Cracked wheat, hominy, rolled oats, rice, sago, tapioca, 
crackers, dry toast, stale bread, corn bread, whole wheat bread, graham 
bread, rice cakes. 

Vegetables. — Spinach, sweet corn, string beans, green peas, lettuce, 
cresses, celery, chicory, asparagus. 

Desserts. — Rice, tapioca or farina pudding, junket, custards, baked 
apples, apple snow, apple tapioca, ripe fruits — raw or stewed. 



282 MODERN NURSING. 

Drinks.— One cup of weak tea, coffee, cocoa, milk and hot water equal 
parts, or one glass of pure, cool water, sipped. 

The patient must not take: — 

Rich soups or chowders, veal, pork, hashes, stews, turkey, potatoes, 
gravies, fried foods, liver, kidney; pickled, potted, corned, or cured 
meats; salted, smoked, or preserved fish; goose, duck, sausage, crabs, 
lobster, salmon, pies, pastry, candies, ice cream, cheese, nuts, ice water, 
malt or spirituous liquors. 

CONSTIPATION. 

The patient may take : — ■ 

Soups. — Meat broths, oyster soup. 

Fish. — Boiled fresh fish of all kinds, raw oysters. 

Meats. — Almost any fresh, tender meat, poultry, game. 

Farinaceous. — Oatmeal, wheaten grits, mush, hominy, whole wheat 
bread, corn bread, brown bread, rye bread. 

Vegetables. — Boiled onions, brussels sprouts, spinach, cauliflower, 
potatoes, asparagus, green corn, green peas, string beans, salads with 
oil. 

Desserts. — Stewed prunes, figs, baked apples with cream, ripe 
peaches, pears, oranges, apples, melons, grapes, huckleberries (the blue 
seedless kind), cherries, raisins, honey, plain puddings, fig puddings, 
apple charlotte. 

Drinks. — Plenty of pure water, cold or hot, black coffee, cocoa, new 
cider, buttermilk, orange juice, unfermented grape juice. 

The patient must not take : — 

Salt, smoked, potted or preserved fish or meats, pork, liver, eggs, 
new bread, puddings of rice or sago, pastry, milk, sweets, tea, nuts, 
cheese, pineapple, spirituous liquors. 

DIARRHOEA. 

The patient may take: — 

Soups. — Milk soup well boiled, clam juice, beef tea. 

Meats. — Scraped fresh beef or mutton well broiled, sweetbread, 
beef juice from freshly broiled steak (all sparingly). 

Eggs. — Lightly boiled or poached on dry toast. 

Farinaceous. — Rice, sago, macaroni, tapioca, arrowroot, dry toast, 
milk toast, toasted crackers. 



DIET FOR VARIOUS DISEASES. 283 

Desserts. — Milk puddings, plain, with sago, rice, tapioca or arrow- 
root (no sugar). 

Drinks. — Tea, toast water, boiled peptonized milk. 

The patient must not take : — 

Oatmeal, wheaten grits, fresh breads, rich soups, vegetables, fried 
foods, fish, salt meats, lamb, veal, pork, brown or graham bread, fruits, 
nuts, pies, pastry, ice cream, ice water, sugars, sweets, custards, malt 
liquors, sweet wines. 

LIVER TROUBLES. 

The patient may take: — 

Soups. — Vegetable soups with a little bread or cracker, light broths. 

Fish. — Boiled fresh cod, bass, sole or whiting, raw oysters. 

Meats. — Tender lean mutton, lamb, chicken, game (all sparingly). 

Farinaceous. — Oatmeal, hominy, tapioca, sago, arrowroot (well 
cooked), whole wheat bread, dry toast, crackers. 

Vegetables. — Mashed potato, almost all fresh vegetables (well 
boiled), plain salad of lettuce, water cress, dandelions. 

Desserts. — Plain milk pudding of tapioca, sago, arrowroot or 
stewed fresh fruit (all without sugar or cream), raw ripe fruits. 

Drinks. — Weak tea or coffee (without sugar or cream), hot water, 
pure, plain, or aerated water. 

The patient must not take : — ■ 

Strong soups, rich made dishes of any kind, hot bread or biscuits, 
preserved fish or meats, curries, red meats, eggs, fat, butter, sugar, 
herrings, eels, salmon, mackerel, sweets, creams, cheese, dried fruits, 
nuts, pies, pastry, cakes, malt liquors, sweet wines, champagne. 

DIABETES. 

The patient may take: — ■ 

Soups. — Soup or broth of beef, chicken, mutton, veal, oysters, 
clams, terrapin or turtle (not thickened with any farinaceous sub- 
stances), beef tea. 

Fish. — Shellfish and all kinds of fish, fresh, salted, dried, pickled, 
or otherwise preserved (no dressing containing flour). 

Eggs. — In any way most acceptable. 

Meats. — Fat beef, mutton, ham or bacon, poultry, sweetbreads, 
calf's head, sausage, kidneys, pig's feet, tongue, tripe, game (all cooked 
free of flour, potatoes, bread or crackers). 



284 MODERN NURSING. 

Farinaceous. — Gluten porridge, gluten bread, gluten gems, gluten 
biscuits, gluten wafers, gluten griddle cakes, almond bread or cakes, 
bran bread or cakes. 

Vegetables. — String beans, spinach, beet tops, chicory, lettuce, plain 
or dressed with oil and vinegar, cucumbers, onions, tomatoes, mush- 
rooms, asparagus, oyster plant, celery, dandelions, cresses, radishes, 
pickles, olives. 

Desserts. — Custards, jellies, creams (without sugar), walnuts, 
almonds, filberts, Brazil nuts, cocoanuts, pecans. 

Drinks. — Tea or coffee (without sugar), pure water, peptonized 
milk. 

The patient must not take: — 

Liver, sugar, sweets or starches of any kind, Avheaten bread or 
biscuits, corn bread, oatmeal, barley, rice, rye bread, arrowroot, sago, 
macaroni, tapioca, vermicelli, potatoes, parsnips, beets, turnips, peas, 
carrots, melons, fruits, puddings, pastry, pies, ices, honey, jams, sweet 
or sparkling wines, cordials, cider, porter, lager, chestnuts, peanuts. 

BRIGHT'S DISEASE. 

The patient may take: — 

Soups. — Broths with rice or barley, vegetable or fish soup. 

Fish. — Boiled or broiled fresh fish, raw oysters, raw clams. 

Meats. — Chicken, game, fat bacon, fat ham (sparingly). 

Farinaceous. — Hominy, oatmeal, wheaten grits, rice, stale bread, 
whole wheat bread, toast, milk toast, biscuits, macaroni. 

Vegetables. — Cabbage, spinach, celery, water cresses, lettuce, mush- 
rooms, mashed potatoes, cauliflower, onions. 

Desserts. — Rice and milk puddings, stewed fruits, raw ripe fruits. 

Drinks. — Pure water, peptonized milk, fresh buttermilk, milk with 
hot water (equal parts), whey, weak tea, toast water. 

The patient must not take : — 

Fried fish, pork, corned beef, veal, heavy bread, hashes, stews, 
batter cakes, lamb, beef, mutton, gravies, peas, beans, pastry, ice cream, 
cakes, coffee, tobacco, malt or spirituous liquors. 

DEBILITY. 

The patient may take : — 

Soups. — Any broth thickened with farinaceous material, chicken 



DIET IN VARIOUS DISEASES. 285 

or beef soup containing chopped meat, rich vegetable soup, whole beef 
tea. 

Fish. — All fresh fish, boiled or broiled, raw oysters. 

Meats. — Beef, mutton, chicken, game, boiled ham, lamb chops or 
cutlet, broiled bacon, tender, juicy steak, hamburger steak. 

Eggs. — Soft boiled, poached, scrambled, raw with sherry wine. 

Farinaceous. — Cracked wheat, rolled oats, mush, sago, tapioca, 
hominy, barley, macaroni, vermicelli, rolls, biscuits, cakes, whole wheat 
bread, corn bread, milk toast, dry toast, brown bread. 

Vegetables. — Nearly all, perfectly fresh and well cooked. 

Desserts. — Custards, egg and milk, rice or apple pudding, baked 
apples, fruit jams, jellies, cocoa junket, marmalade, sweet fruits, calf's 
foot jelly. 

Drinks.- — Cocoa, chocolate, milk, hot, cold, or peptonized, pure 
water, plain or aerated. 

The patient must not take : — 

Hashes, stews, cooked oysters or clams, pork, veal, thin soups, 
turkey, salt meats (except ham and bacon), cabbage, cucumbers, 
turnips, carrots, squash, spices, pickles, vinegar, pies, pastry, bananas, 
pineapples, 

OBESITY. 

The patient may take : — 

Fish. — Nearly all fresh fish, boiled. 

Meats. — Lean beef, mutton or lamb, chicken, game (sparingly). 

Eggs. — Boiled or poached on toast. 

Farinaceous. — Stale bread, dry toast or crusts (sparingly). 

Vegetables. — Spinach, lettuce, celery, cresses, asparagus, cauliflower, 
onions, white cabbage, tomatoes, radishes, olives. 

Desserts. — Ripe fruits only — acid varieties preferable. 

Drinks. — One cup of tea or coffee, without milk, cream, or sugar, 
or one glass of pure water, sipped at the end of the meal. 

The patient must not take : — 

Soups, salmon, bluefish, eels, salt fish, pork, veal, sausage, made 
dishes, fats, potatoes, macaroni, oatmeal, hominy, spices, rice, beets, 
carrots, turnips, parsnips, puddings, pie, pastry, cake, sugars, sweets, 
milk, cream, malt or spirituous liquors, beers, sweet wines, champagne. 



286 MODERN NURSING. 

RHEUMATISM. 

The patient may take : — 

Soups. — Mutton broth, chicken or beef tea, in small quantities. 

Fish. — Raw clams or oysters, fresh fish (whiter kinds), boiled. 

Meats. — Chicken, calf's head, sweetbread, tripe, broiled fat bacon 
or boiled ham (all sparingly). 

Farinaceous. — Whole wheat, corn or brown bread, arrowroot, rice. 
dry toast, milk toast. 

Vegetables. — Spinach, green peas or cabbage (well boiled), celery, 
lettuce, cresses, radishes. 

Desserts. — Milk, rice or arrowroot pudding (all without sugar), 
junket. 

Drinks. — Tea (without sugar), buttermilk, pure water, plain, with 
lemon or lime juice (no sugar). 

The patient must not take: — 

Pork, veal, turkey, goose, duck, fried fish or meats, cooked oysters 
or clams, salted, dried, potted, or preserved fish or meats (except fat 
bacon or ham), crabs, salmon, lobster, eggs, rich made dishes, gravies, 
potatoes, tomatoes, beans, asparagus, mushrooms, candies, rich pud- 
dings, pies, pastry, nuts, cheese, coffee, cider, malt liquors, wines. 

GOUT. 

The patient may take : — 

Soups. — Fresh fish soups, vegetable broths, clear. 

Fish. — Raw oysters, fresh fish, boiled. 

Meats. — Fat bacon, boiled or broiled chicken, game (all sparingly). 

Farinaceous. — Cracked wheat, oatmeal, rice, sago, hominy, whole 
wheat bread or biscuits, rye bread, graham bread or rolls, crackers, 
dry toast, milk toast, macaroni. 

Vegetables. — Mashed potato, green peas, string beans, spinach, 
cabbage, cucumbers, cresses, lettuce, celery. 

Desserts. — Plain milk pudding, junket, rice and milk, stewed fruits 
(all without sugar). 

Drinks. — Weak tea (no sugar), milk, buttermilk, toast water, pure 
water, cold or hot. 

The patient must not take: — 

Veal, pork, goose, duck, turkey, salted, dried, potted, or preserved 
fish or meat (except fat bacon), eels, mackerel, crabs, salmon, lobster, 
eggs, rich soups, gravies, patties, tomatoes, sweet potatoes, asparagus, 
mushrooms, rhubarb, lemons, pickles, vinegar, fried or made dishes, 



DISHES FOR THE SICK. 287 

rich puddings, spices, pies, pastry, sweets, cheese, nuts, dried fruits, 
tobacco, coffee, cider, malt liquors, sweet wines, champagne. 

PHTHISIS (CONSUMPTION). 

The patient may take : — 

Soups. — Turtle or oyster soup, mutton, clam, or chicken broth, 
puree of barley, rice, peas, beans, cream of celery or tomatoes, whole 
beef tea, peptonized milk gruel. 

Fish. — All kinds of fresh fish, boiled or broiled, oysters or clams, 
raw, roasted, or broiled. 

Meats. — Rare roast beef or mutton, lamb chops, ham, fat bacon, 
sweetbreads, poultry, game, tender steaks, hamburger steak, rare. 

Eggs. — Every way except fried. 

Farinaceous. — Oatmeal, wheaten grits, mush, hominy, rice, whole 
wheat bread, corn bread, milk toast, biscuits, muffins, gems. 

Vegetables. — Potatoes, baked, boiled, or creamed, string beans, 
spinach, onions, asparagus, tomatoes, green peas (all well cooked), 
lettuce, cresses, celery. 

Desserts. — Farina, sago, tapioca, apple or milk pudding, floating 
island, custards, baked or stewed apples with fresh cream, cooked 
fruits, rice with fresh cream. 

Drinks. — Fresh milk, cool, warm, or peptonized, cocoa, chocolate, 
buttermilk, pure water, tea, coffee. 

The patient must not take: — 

Fried foods, salt fish, hashes, gravies, veal, pork, carrots, parsnips, 
cabbage, beets, turnips, cucumbers, macaroni, spaghetti, sweets, pies, 
pastry, sweet wines. 

DISHES FOR THE SICK. 
PEPTONIZED FOODS. 

For peptonizing milk and other foods either the tubes or essence of 
pepsin or tablets may be used. Junket tablets are convenient for use. 
These preparations are to be procured from any drug store, as they are 
in constant demand. 

Immediate Process. 
Put two tablespoonfuls (1 ounce) of cold water in a goblet or 
glass; dissolve in this one quarter the contents of a peptonizing tube; 



288 MODERN NURSING. 

add eight tablespoonfuls (4 ounces) of warm milk; drink immediately, 
sipping slowly. 

If half a pint of milk is desired, double the proportions of water, 
peptonizing powder, and milk. 

By the Cold Process. 

Into a clean, quart bottle put the powder contained in one of the 
Fairchild peptonizing tubes and a teacup ful (gill) of cold water; 
shake, then add a pint of fresh, cold milk, shake the mixture again and 
immediately place the bottle on ice, without subjecting it to the water- 
bath or any heat. Place the bottle' directly in contact with the ice. 

When needed, shake the bottle, pour out the required portion, and 
use in the same manner as ordinary milk. 

Partially Peptonized Milk. 

Put into a clean agate ware or porcelain-lined saucepan the 
powder contained in one of the peptonizing tubes, and a teacupful 
(gill) of cold water; stir well; then add a pint of cold, fresh milk. 
Heat with constant stirring until the mixture boils. The heat should 
be so applied that the milk will come to a boil in ten minutes. When 
cool, strain into a clean bottle, cork well, and keep in a cold place. 
When needed, shake the bottle, shake out the required portion, and 
serve cold or hot, as directed by the physician in charge. 

N. B. — Milk so prepared will not become bitter. 

Peptonized Milk. 

Into a clean, quart bottle put the powder contained in one of the 
peptonizing tubes, and a teacupful (gill) of cold water; shake, then 
add a pint of fresh, cold milk, and shake the mixture again. Place 
the bottle in water so hot that the whole hand can be held in it without 
discomfort (about 115 F.). 

Keep the bottle there five or ten minutes as directed. 

At the end of that time put the bottle on ice at once to check 
further digestion and keep the milk from spoiling. 

Place the bottle directly in contact with the ice. 

The degree of digestion is very simply regulated by the length of 
time in which the milk is kept warm. 

Peptonized Milk Gruel. 
Thick, well boiled, hot gruel, one-half pint. 
Milk, fresh, cold, one-half pint. 



DISHES FOR THE SICK. 289 

Mix and strain into a small pitcher or jar, and immediately add 
the contents of one peptonizing tube; mix well. Let it stand in the 
hot water bath, or warm place, for five minutes, then put in a clean 
bottle and place on ice. Serve hot or cold. 

Gruel made from arrowroot, flour, barley, oatmeal, etc., will serve 
for the purpose. In each instance the farinaceous material should 
be boiled with water until the starch granules have been thoroughly 
swollen, broken up, and incorporated with the water. 

To Make Junket and Whey, Using Essence of Pepsin. 

Junket. — Into a clean saucepan put one-half pint of fresh, cool 
milk, heat it lukewarm (not over ioo° F.) ; then add one teaspoonful 
of essence of pepsin, and stir just enough to mix; divide quickly into 
small cups or glasses and let stand until firmly jellied, when the junket 
is ready for use, just as it is, or with sugar; it may be placed on ice 
and taken cold. 

Whey. — Into a clean saucepan put one pint of fresh, cool milk, 
heat it lukewarm (not over ioo° F.); then add two teaspoonfuls of 
essence of pepsin, and stir just enough to mix; let it stand until firmly 
jellied, then beat with a fork until it is finely divided; now strain and the 
whey (liquid part) is ready for use ; keep in a bottle near ice. 

Whey is a highly nutritious fluid food, containing in solution the 
sugar and the salts (the mineral constituents) of the milk, and holding 
also in suspension a considerable portion of caseine and fat (cream), 
which pass through the strainer. It is peculiarly useful in many 
ailments, and always valuable as a means of variety in diet for the 
sick. It is frequently resorted to as a food for infants to tide over 
periods of indigestion, summer complaints, etc. 

General Directions for Making Junket with Junket Tablets. — Junket 
tablets contain nothing but pure rennet ferment and a little pure table 
salt; they contain no chemicals, cornstarch, or gelatine. The results 
they produce in milk may seem marvelous, yet you will remember that 
from pure milk and cream such palatable and solid foods as butter and 
cheese are made. If you will follow a few plain, easy directions, you 
can, with the aid of junket tablets, combine all the nourishing, health- 
ful properties of butter and cheese contained in pure' milk into a milk 
jelly, exquisitely delicious, smooth, and velvety. You cannot use milk 
or cream that has been scalded or overheated and then cooled, or milk 



290 MODERN NURSING. 

treated with preservatives, or watered, evaporated, condensed, pasteur- 
ized, or sterilized milk. 

Milk must be just warm — that means lukewarm, blood warm, 
or 98 F. Temper it just so that it does not taste hot or cold, or feel 
hot or cold to the finger. While the milk is warming, which may be 
done over the fire in a pan of hot water, stir in the sugar and add 
flavors or colors to suit the taste. When the milk is just lukewarm 
remove it at once from the fire, or it will overheat. 

Have the junket tablet dissolved, ready for use, in a tablespoonful 
of cold water. Do not dissolve it in warm or hot water or in milk. 

Eight junket or sherbet glasses hold one quart of junket. Have 
them all ready in a warm room where they will not be disturbed. In 
cold weather warm the dish before using. 

Stir the dissolved junket tablet quickly into the warmed, sweet- 
ened, and flavored milk (one quick stir of the spoon is enough), then 
pour at once into the cups, filling them two-thirds full. If you prefer, 
pour the whole quart into one large dish, but in serving from the 
large dish the junket is broken, whey forms quickly, and the dainty 
appearance of the dessert is destroyed. t Therefore individual dishes 
are preferable. 

Every housekeeper knows that in baking cake or custard it must 
not be shaken or roughly handled, or it will fall. Be just as careful 
with junket while it is jellying, or it will break loose from the dish 
and become watery. Therefore do not move, jar, or disturb it for 
ten minutes. When firm remove carefully to a cool place or the ice 
chest until ready to serve. 

Devonshire Junket. 

Stand rich, twelve-hours-old milk where it will come very slowly to 
scald, and let it remain at that temperature ten or fifteen minutes; then 
set away to get cold. 

Make a plain junket, and when ready to serve lift the cream from the 
scalded milk, place it on top of the junket and serve ; or it may be served 
in the good old English style with clotted cream and port wine. 

Coffee Junket. 

Make a half-cup of strong coffee by pouring a half-cup of freshly 
boiling water over two tablespoonfuls of pulverized coffee. Heat one 
and three-quarters pints of milk until lukewarm, add the coffee and a half- 



DISHES FOR THE SICK. 291 

cup of sugar. Stir until dissolved. Add the dissolved tablet and finish 
as in plain junket. Serve with whipped cream heaped on top. 

Whey. 

The junket tablet may be used conveniently in the preparation of 
whey, a refreshing and slightly stimulating beverage, very useful in the 
sick room, especially in febrile conditions. 

As in the coagulation of milk the curd takes w T ith it the caseine and 
most of the fat, the whey contains only the milk-sugar and salts dis- 
solved in the water, with a very small portion of nitrogenous substance. 
It may be considered mildly nutritive and very wholesome ; if fresh, it is 
readily assimilated by the stomach, requiring no labor to fit it for absorp- 
tion, and contains in a degree every element of nutrition. Whey is 
strongly recommended as a most satisfactory food in cholera infantum, 
and is far more suitable than any other food preparation as a temporary 
substitute for milk. For adult invalids whey is a most pleasing and 
nutritious drink. 

To Prepare Whey. 

Have the required quantity of milk just lukewarm to ioo° F. and add 
the dissolved tablet — one to each quart of milk. Allow it to jelly in a 
warm place. Then break up the curd and strain through two thicknesses 
of cheese cloth, being careful to remove all the caseine. Whey should be 
used cold, with or without sweetening, and flavored with any desired 
flavoring. 

Junket from Cream. 

This may be made the same as that made with milk, using cream in 
the place of milk and in the same proportions. When ready to use turn 
out on to a dish and heap round the base some tart jelly, and serve at 
once. 

Custard Junket. 

Put over the fire to scald a half-pint of milk. Beat together two 
eggs and a quarter cup of sugar until light, stir into the scalding milk, 
and stir constantly until it thickens ; take at once from the fire. Have a 
pint and a half of milk in which is dissolved another quarter cup of sugar, 
add the cooled custard slowly, and mix evenly. When lukewarm add a 
teaspoonful of vanilla and the dissolved tablet, and finish as the plain 
junket. 



292 MODERN NURSING. 

Junket with Raw Egg. 

Separate two eggs, beat the whites until perfectly dry ; beat the yolks 
until thick. Add them to the whites gradually, beating constantly. Heat 
one pint of milk until lukewarm, dissolve in it two tablespoonfuls of 
sugar, add a half teaspoonful of flavoring. Pour this over the beaten 
eggs, stir in a half junket tablet dissolved in a dessert-spoonful of cold 
water and turn quickly into glasses. Stand in warm place for half an 
hour until firm, then put in cold place. 

Wine Junket. 

Dissolve two tablespoonfuls of sugar (granulated) in three table- 
spoonfuls of wine or brandy; add one teaspoonful of lemon juice and 
a little grated nutmeg. Heat one pint of fresh milk, just warm, as for 
plain junket. Take it from the fire ; stir in the wine, then the dissolved 
tablet (one-half a tablet to the pint), and proceed as for plain junket. 
If required, as a medium for administering wine, brandy, or whisky in 
sickness, as much as four tablespoonfuls may be used. 

Junket Eggnog. 

Beat the yolks of two eggs and a teaspoonful of sugar to a light 
cream, whip the white of the eggs to a stiff froth, mix them together 
gradually, beating constantly. Dissolve four tablespoonfuls of sugar in 
three tablespoonfuls of Jamaica rum and mix with the beaten egg. Have 
one quart of milk or cream just lukewarm, stir in the mixture of egg, 
sugar, and rum, then stir in quickly one junket tablet, already dissolved 
in one tablespoonful of cold water, and pour immediately into warm jun- 
ket glasses, sprinkle grated nutmeg over the top of each. Stand in 
warm room a half hour. When firm, put in a cool place. This is very 
nourishing and strengthening for invalids, and can readily be retained by 
the most delicate stomach. Any other liquor may be used in place of the 
rum. 

Whipped Cream. 

Take half a cup of heavy cream, add one cup of rich milk, two 
tablespoonfuls of powdered sugar, and two tablespoonfuls of wine or 
brandy, or half a tablespoonful of other flavoring. Serve the junket with 
*.he whip above it. 

Champagne Junket. 

Dissolve one-fourth cup of granulated sugar in three tablespoonfuls 
of champagne; add one teaspoonful of Chr. Hansen's lemon flavor. 



DISHES FOR THE SICK. 293 

Dissolve half a junket tablet in a dessert-spoonful of cold water. Heat 
one pint of milk lukewarm. Take from the fire; stir in the wine, then 
the dissolved half tablet, and pour into champagne glasses. 

Koumyss. 

This is a preparation of milk which is very useful for children and 
adults during convalescence from acute or subacute, or exhausting 
diseases. Even young children of three or four years will take a fancy 
to it if it is not made too sour by continuing the fermentation process 
too long. The liquid is prepared as follows : Add to one pint clear, 
perfectly fresh milk two teaspoonfuls of sugar and place it, after shack- 
ing thoroughly in a clean beer or claret bottle. Then add one-sixth cake 
Fleischmann's yeast and tightly cork the bottle, standing it in a warm 
place, or a water bath at 99 to ioo° F. for from eight to ten hours. Then 
place in a cool place or on the ice and use as needed. It must be re- 
membered that the development of carbonic acid gas is very great in this 
liquid, and if an ordinary cork is inserted it must be tied in before heat 
is applied. Further than this, the cork must be pulled very gently or the 
liquid will spurt all over the room. The best thing to use to open a 
bottle of koumyss is a "champagne tap,'' by means of which the liquid 
may be drawn off as needed. — Dr. Hare, in Practical Therapeutics. 

SOUPS. 

Beef Tea. 

Cut up a pound of rump steak into small pieces, and put it into a 
bottle (wide-mouthed fruit jar), putting a very small quantity of luke- 
warm water into the bottle with it, cork tightly and put the bottle into 
a kettle of warm water; the water should be allowed to boil for a con- 
siderable time; the bottle should then be removed and the juice drained 
off. The tea may be salted a little, and a teaspoonful given at a time. 

Another Beef Tea. 

The latest and most approved method of making beef tea, is to take 
a half pound of good steak, broil slightly over hot coals; then lay in 
a shallow dish, and, with a sharp knife, gash it on both sides until it 
is cut into mere shreds; then pour half a pint of boiling water over it, 
and scrape hard for a few moments, when all the nutriment of the beef 
will be extracted. This is the easiest, quickest, and, by many, thought 
to be the best method. 



294 MODERN NURSING. 

Chicken Tea. 
Take off the skin and all the fat of the fowl, and boil it till very tender, 
with just enough water to cover it, and add a little salt. Take the chicken 
out of the liquor when boiled, and let the liquor remain until cold to let 
all the fat rise to the surface, which should then be skimmed off. The 
tea should be heated when given to the patient. It is a very delicate, 
nourishing food, and will set well on the stomach when so weak as to 
be able to retain but little food. 

Chicken Broth. 
Take half a chicken, remove all the fat, cut the meat in small pieces 
and break the bones ; put into a vessel with three pints of boiling water ; 
boil for an hour, season with salt and strain. 

Lamb Broth. 
Stew a lamb chop in a quart of water until it comes to shreds, add a 
teaspoonful of barley or rice, and a little salt and onion, if desired. 
Strain, and add a little parsley. 

Oyster Soup. 
Take of oysters, a half dozen; milk, a teacupful, with enough liquor 
of the oysters to make a bowl; a few allspice and cloves, a nice lump of 
butter, pepper, and salt. Bring to a boil and skim. Then throw in the 
oysters and simmer. Add a few toasted crackers before removing from 
the fire. 

Mutton Tea. 

Take one pound of mutton, remove the fat and cut the meat in small 
pieces ; pour half a pint of boiling water over it, and let it stand near a 
fire for half an hour, and then boil for one hour, strain through a sieve 
or cloth, add salt to suit the taste. A very nourishing diet. 

Vegetable Soup. 
Take two Irish potatoes, one onion, and a piece of bread ; place them in 
a quart of water ; add a little celery or parsley toward the close of the boil- 
ing. Salt and pepper may be employed at pleasure. 

Peptonized Beef. 
Take one pound minced lean beef, cold water one-half pint; 
mix in a saucepan. Cook over a gentle fire, stirring constantly until 
it has boiled a few minutes. Then pour off the liquor for future use; 



DISHES FOR THE SICK. 295 

beat the meat to a paste, put it into a clean fruit jar with one-half 
pint of cold water and the liquor poured over the meat and add : — 

Extract of Pancreas, 20 grains. 

Sodium Bicarbonate (Baking Soda), 15 grains. 

Shake well together; set aside in a warm place, at about no° or 115 
F. for three hours, stirring or shaking occasionally; then boil quickly. 
The liquid may be strained or clarified by the white of an egg in the 
usual manner ; season to taste, with salt and pepper. In the great majority 
of cases it is not necessary to strain the peptonized liquor, for the portion 
of meat remaining undissolved will have been so softened and acted upon 
by the pancreatic extract that it will be in very fine particles, and dif- 
fused in an almost impalpable condition, and is therefore ready for assimi- 
lation in the body. — Dr. Hare, in Practical Therapeutics. 

Peptonized Oysters. 
Peptonized oysters are prepared by mincing six or twelve large oysters 
and adding to them, when mixed with a moderate amount of their liquid, 
five grains of pancreatin, or peptonizing powder, and twenty grains of 
sodium bicarbonate. The cup containing this mixture is now placed in 
warm water at ioo° F. and allowed to remain there from ten to twenty 
minutes, according to the degree of digestion desired. After this the 
liquid mass is quickly brought to a boil to cook the oysters and stop 
digestion, and is served with pepper and salt as required. Any condiment 
or flavoring substance may be used. — Dr. Hare, in Practical Therapeutics. 

FARINACEOUS FOODS. 

Panada. 
Break into a bowl three good-sized crackers (arrowroot or oatmeal 
are nice) broken into small pieces; pour upon them boiling water and 
cover close for a minute, then add a tablespoonful of white sugar and a 
little pure milk. It is an excellent breakfast or supper for a child or an 
invalid. Instead of the milk the juice of a lemon may be squeezed in 
and another teaspoonful of sugar added, if there is fever. 

Indian or Oat Meal Gruel. 
This simple refreshment is invaluable in sickness, and is made with 
little trouble and less expense, yet it is very seldom prepared exactly right. 
One tablespoonful of fine Indian or oat meal, mixed smooth with cold 



296 MODERN NURSING. 

water and a little salt; pour upon this a pint of boiling water, and turn 
into a saucepan to boil gently for half an hour ; thin it with boiling water 
if it thickens too much, and stir frequently; when it is done a tablespoon- 
ful of cream or a little new milk may be put in to cool it after straining, 
but if the patient's stomach is weak it is best without either. Some persons 
like it sweetened and a little nutmeg added, but to many it is more pala- 
table plain. 

Arrowroot Gruel. 
Add a teaspoonf ul of arrowroot to half a pint of boiling water ; mix 
well, add half a pint of milk and boil together for two or three minutes ; 
sweeten to the taste. A little lemon juice or wine may be added. 

Water Gruel. 
Corn or oat meal, two tablespoonfuls ; water, one quart. Boil for ten 
or fifteen minutes, and add sugar or salt, if desired by the patient. 

Ground Rice Gruel. 
Ground rice, one heaping tablespoonf ul ; ground cinnamon, half a 
teaspoonf ul ; water, one quart. Boil slowly for fifteen or twenty minutes, 
add the cinnamon when it is nearly done boiling, strain and sweeten. 

Sago Gruel. 
Sago, two tablespoonfuls; water, one pint. Boil until it thickens, 
frequently stirring. Wine, sugar, and nutmeg may be used if desirable. 

Thickened Milk. 
With a little milk, mix smooth a tablespoonful of flour and a pinch of 
salt. Pour upon it a quart of boiling milk, and when it is thoroughly 
mixed, put all back into the saucepan and boil up at once, being careful 
not to burn, and stirring all the time, to keep it perfectly smooth and free 
from lumps. Serve with slices of dry toast. It is excellent for diarrhoea; 
this alone will often cure it by scorching the flour before mixing with 
the milk. 

Wheat Balls. 

Tie half a pound of wheat flour in thick cotton and boil it three or 
four hours ; then dry the lump, and grate it when you use it. Prepare a 
gruel of it by making a thin paste, and pouring into boiling milk and 
water, and flavor with salt. This is good for teething children. 



DISHES FOR THE SICK. 297 

Suet Boiled in Rice. 
Take some rice milk (boiled rice and milk), and boil it. When 
nearly boiled enough, add a dessert-spoonful of beef suet, already minced 
as small as bread crumbs. Boil slowly for a few minutes, and take off 
the scum as it rises. Or the suet may be inclosed in a muslin bag. It 
must be eaten hot. 

Oatmeal. 
Take half a teacup of oatmeal, add one pint of cold water; put into 
a tin dish in a kettle of water and boil slowly for two hours, adding more 
hot water if necessary. Another excellent way to cook oatmeal is to 
steam it. 

Oatmeal Jelly. 
One cup oatmeal, one and one-half pints water, and a little salt. 
Bake in the oven until it thickens to a starchy substance. Serve warm, 
with sugar and cream. 

Tapioca Jelly. 
One-half cup tapioca, two cups water, one-half cup sugar, juice and 
rind of one lemon. Cook the tapioca in the water one hour, using a 
double boiler. At the end of that time add lemon and sugar and three 
teaspoonfuls of brandy. Strain and serve cold with milk. This is one 
of the few things for the sick of which enough can be prepared for 
several meals. 

Parched Rice. 

Cook in a custard kettle one-half cup parched rice in one pint salted 
boiling water. Serve with cream and sugar. 

Mush. 
The water must be fresh, salted, and boiling when the corn meal is 
sprinkled in, so that the starch cells may burst. It is best to use a porce- 
lain lined or agate kettle. Stir constantly with one hand and sprinkle 
the meal with the other. Take any amount of water and sprinkle in meal 
until the mixture is quite thick, when a few sprinklings of flour will 
seem to make it more palatable. Cover closely and let stand on back 
of stove for an hour or two, or even half a day. Do not stir after remov- 
ing from the fire, as this permits the flavor to escape with the steam. 

Dry Toast. 
Cut your slices of bread even and not too thick. Toast before a clear 



2 9 B • MODERN NURSING. 

fire, a nice light brown. Cover with a napkin and serve quickly, while 
it is hot. Dry toast is not always good for invalids, especially when the 
bowels are confined and it is desirable to keep them open. In this case 
graham bread, not toasted, is much better. 

Milk Toast. 
This is a favorite dish with nearly all sick people, when they are get- 
ting well. Cut stale bread in rather thin slices, toast a fine brown, and 
lay them in a deep dish. Meanwhile boil a quart of new milk in a lined 
saucepan, in which you have first put a very little cold water, to prevent 
burning. As soon as it boils pour it over the toast, cover and serve 
quickly. For an invalid no butter should be put in the milk. Some 
people put in a thickening of flour, but this spoils it for many. 

"Soft" Toast. 

Some invalids like this very much indeed, and nearly all do when it 
is nicely made. 

Toast well, but not too brown, a couple of thin slices of bread, put 
them on a warm plate and pour over boiling water; cover quickly with 
another plate of the same size and drain the water off ; remove the upper 
plate, butter the toast, put in the oven one minute and then cover again 
with a hot plate and serve at once. 

Watered Toast. 

Toast, several pieces of bread and carefully butter, so that the butter 
is equally distributed. Salt and pepper to taste, and finally pour as much 
boiling water on the edges of the crust as is necessary to thoroughly 
soften, and serve to the patient. 

This is a much more agreeable dish than might be imagined, and is 
useful when milk toast is distasteful. 

Almond Bread for Diabetics. 
Take of blanched sweet almonds one-quarter pound; beat them as 
fine as possible in a stone mortar ; remove the sugar contained in this meal 
by putting it into a linen bag and steeping it for a quarter of an hour in 
boiling water, acidulated with vinegar; mix this paste thoroughly with 
three ounces of butter and two eggs. Next add the yolks of three eggs 
and a little salt, and stir well for some time. Whip up the whites of 



DISHES FOR THE SICK. 299 

three eggs and stir in. Put the dough thus obtained into greased molds 
and dry by a slow lire. — Dr. Hare, in Practical Therapeutics. 

Bran Bread for Diabetics. 

Take a sufficient quantity (say one quart) of wheat bran; boil it 
in two successive waters for one-quarter hour each time, straining it 
through a sieve. Then wash it in cold water (on the sieve) until the 
water runs off perfectly clear. Squeeze the bran in a cloth as dry as 
possible, then spread it thinly on a dish and place it in a slow oven. If 
put in at night, let it remain until morning, when, if perfectly dry and 
crisp, it will be fit for grinding. 

The bran thus prepared must be ground in a fine mill and sifted 
through a wire sieve of such fineness as to require the use of a brush to 
pass it through; that which remains in the sieve must be ground again 
until it becomes quite fine. 

Take of this bran powder three ounces (some patients use four 
ounces) and other ingredients as follows: Three newly laid eggs, one 
and one-half ounces (or two ounces if desired) butter, and about one- 
half pint milk; mix the eggs with a little of the milk and warm the but- 
ter with the other portion; then stir the whole well together, adding a 
little nutmeg or ginger, or any other agreeable spice. Bake in several 
patty tins, which must be well buttered, in a rather quick oven for about 
one-half hour. The cakes, when baked, should be a little thicker than a 
ship's biscuit ; they may be eaten w T ith meat or cheese at breakfast, dinner, 
and supper ; at tea they require rather a free allowance of butter, or they 
may be eaten with curd or other soft cheese. It is important that the 
above directions as to washing and drying the bran should be exactly 
followed, in order that it may be freed from starch and rendered friable. 
The bran in its common state is soft, and not easily reduced to a fine 
powder. In some seasons of the year, or if the cake has not been well 
prepared, it changes more rapidly than is convenient, owing to moisture. 
This may be prevented by placing the cake before the fire for five or ten 
minutes every day. — Dr. Hare, in Practical Therapeutics. 

EGGS. 

Eggnog. 
Beat an egg until it foams, put it into a glass and fill the glass with 
cool, rich milk; add from a teaspoonful to a tablespoonful of brandy, 
and sweeten to taste. 



300 MODERN NURSING. 

Milk and Eggs. 
Beat up a fresh egg with a grain of salt, pour upon it a pint of boiling 
milk, stirring all the time. Serve hot, with or without toast. It is good 
in case of weakness, for an early breakfast, or for a traveler before start- 
ing on a journey. 

Soft Boiled Eggs. 
Fresh eggs for invalids who like them cooked soft should be put in 
a pan of boiling water, and set on a part of the stove where they will not 
boil, for several minutes. At the end of that time they will be like jelly, 
perfectly soft, but beautifully done and quite digestible by even weak 
stomachs. 

Soft Custard. 
Milk, a pint. Place it to boil; while boiling, take of eggs, three; 
separate them, and beat up the yolks with sugar enough to sweeten to 
the taste, and with cornstarch, a teaspoonful, rubbed in smoothly. Then 
pour this egg and cornstarch mixture into the pint of boiling milk; boil 
for a few minutes, and stir constantly to prevent lumping and burning. 
When the whole becomes a thick, creamy mass, remove. Have ready, 
in a dish, some stale sponge cake, slightly wet with brandy or wine. 
Pour the custard over it, and cover all with the white of the three eggs 
whipped stiff, with a half teacup ful of pulverized sugar, and flavored 
with vanilla. 

Egg Toast. 
Make a soft toast and have ready one or more fresh eggs, which 
have been boiled twenty minutes; remove the shells, cut them in 
slices and place upon the toast, with a little butter, pepper, and salt; 
without the butter they may be eaten with impunity by the most delicate 
invalid, as an egg cooked for twenty minutes is really more easy of 
digestion than one that is termed "soft boiled." 

Poached Eggs. 
Into boiling milk which has been seasoned with butter and salt drop 
fresh eggs, cover, and let simmer for three minutes, when they may be 
removed to a piece of buttered toast. The toast may or may not have 
been softened with the hot milk, as desired. 



DISHES FOR THE SICK. 301 

DESSERTS. 

Tapioca Cup Pudding. 
This is very light and delicate for invalids. An even tablespoonful 
of tapioca, soaked for two hours in nearly a cup of new milk. Stir into 
this the yolk of a fresh egg, a little sugar, a grain of salt, and bake in a 
cup for fifteen minutes. A little jelly may be eaten with it, or a few 
fresh strawberries. 

Invalid Cup Pudding. 

One tablespoonful of flour, one egg; mix with cold milk and a pinch 
of salt, to a batter. Boil fifteen minutes in a buttered cup. Eat with 
sauce, fruits, or plain sugar. 

Invalid Apple Pie. 
Slice up one or more nice, tart apples in a saucer, sweeten with 
white sugar and cover with a moderately thick slice of bread, buttered 
slightly on the underside. When the bread is nicely browned, the apples, 
if of a tender kind and thinly sliced, will be done. 

Roast Apples. 
These can nearly always be eaten with safety, when they are eaten 
with relish. Choose good sized, fair apples of a tart and juicy, but not 
of a sour, kind. Rub them off clean, and put them in rather a slow oven, 
which may increase in warmth, so that they shall be thoroughly done 
in an hour. When so soft that the savory pulp breaks through the 
browned skin in every direction, take them out, sift white sugar over 
them, and carry one at a time on a saucer to the patient 

Stewed Prunes. 
These are extremely good in smallpox, measles, scarlet fever, and the 
like, both as food and medicine. Get the box prunes, as they will not 
need washing, and because they are generally of a much better quality than 
the open sort. Soak them for an hour in cold water, then put them in a 
porcelain lined saucepan, with a little more water if necessary, and a 
little water and crushed sugar. Cover and let them stew slowly an hour, 
or until they are swollen large and quite soft. They are excellent as an 
accompaniment to breakfast for a sick woman. 



3 02 MODERN NURSING. 

Grange Gelatixe. 
Soak one teaspoonful granulated gelatine in one tablespoonful 
cold water one-half hour, add one tablespoonful boiling water 
and dissolve. Add two tablespoonfuls sugar, three tablespoonfuls 
orange juice, and two teaspoonfuls lemon juice ; strain through 
cloth and strainer into cold, wet molds, and set away to harden. 
Cut orange in half, crosswise : remove pulp and strain. Fill with 
the jelly, and when firm cut into thirds, leaving the rim filled with 
the jelly. Place on a plate and serve with whipped cream in the 
center. (Individual recipe.) 

Oraxge Charlotte. 
Soak two teaspoonfuls gelatine in one tablespoonful cold water 
one-half hour: add one-third cup boiling water and dissolve. Add 
one-third cup sugar, three tablespoonfuls orange juice, and one 
tablespoonful lemon juice, and set on ice to cool, stirring frequently. 
When hardened, fold in the stiffly-beaten whites of two e^s: mix 
thoroughly and pour into cold, wet molds, and set away to harden. 
Remove by dipping mold in warm water. Serve with soft custard. 
(Individual recipe.) 

Sxow Pudding. 

Soak two teaspoonfuls granulated gelatine in three tablespoon- 
fuls cold water, and add one-third cup boiling water and dissolve. 
Add three tablespoonfuls sugar and one and a half tablespoonfuls 
lemon juice. When sugar is dissolved, set on ice to cool, stirring 
occasionally. When jelly is firm, fold in the stiffly-beaten white of 
one Qgg and pour into cold, wet molds, and place on ice to cool. 
When solidified, remove and serve with soft custard. (Individual 
recipe.) 

Strawberry Mousse. 

Soften one-quarter box shredded gelatine, or one tablespoonful 
granulated gelatine in one-quarter cup cold water: add one-quarter 
cup boiling water and dissolve. Whip one pint cream until stiff, 
and add one-half cup powdered sugar. Add one cup strawberry 
juice to the gelatine, fold the cream in carefully, turn into a wet 
mold, and pack in salt and ice for two hours. Before serving, turn 
out of mold on to a glass dish and garnish with fresh strawberries 
and whipped cream. 



BOOK IV. 

LOCAL DISEASES OF ADULTS. 

john h. Mccormick, Editor-in-Chief. 

DISEASES OF THE HEAD. 

DANDRUFF OR SEBORRHOEA. 

A diseased condition of the sebaceous glands of the skin. When it 
affects the head it is commonly known as Dandruff and it takes the form 
of very small flakes or scales or crusts. It appears on the forehead and 
nose in the form of an oily coating. Scales or flakes also appear in any 
part of the body. These latter forms are known as Seborrhcea. 

Causes. — While there is no doubt that anaemia (deficiency of blood) 
contributes to the condition, the cause of the disease is not well under- 
stood. Women are more subject to it than men; and brunettes than 
blondes. It is this same condition of the sebaceous glands that causes 
the body of a newborn infant to be covered with a sebaceous secretion 
producing the condition known as vernix caseosa. 

Symptoms. — The well-known dry, more or less greasy, gray, brown, 
or yellow flakes or crusts adhere to the scalp and sometimes itch annoy- 
ingly. It appears on the face in the form of a greasy, oily coating on 
the forehead or nose. It cannot be mistaken for eczema, because 
dandruff scales are always dry, while eczema at some stage is moist with 
a watery secretion ; dandruff scales are pale in color and very abundant ; 
eczema scales are few in number and are very red in color. 

Prognosis. — While it is an obstinate disease, it will yield to persistent 
treatment. Its termination is usually favorable, but the danger of bald- 
ness caused by it must not be overlooked. 

Treatment. — As the healthy condition of the sebaceous glands of the 
skin depends upon the general health, a radical cure requires that a course 
of tonics be given. For this purpose use : — 

Fowler's Solution of Arsenic, I dram. 

Bitter Wine of Iron, 4 ounces. 

One teaspoonful of this solution in a wineglass of water after each 
meal. 



3 04 DISEASES OF ADULTS. 

Or:— 

Wine of Iron, ij^ ounces. 

Simple Syrup, 2 drams. 

Solution of Potassium Arsenite, 2 drams. 

Water, , 2 ounces. 

Take a teaspoonful after each meal in a wine glass of water. 

For local treatment, which is of the utmost importance, the following 
will prove efficacious : — 

The scalp should be thoroughly anointed with olive oil to soften the 
crusts and then washed with warm water and tincture of green soap 
every second day for a week, and afterward washed with tincture of 
green soap once a week until the condition disappears. Apply daily as 
a hair dressing : — 

Oil of Bergamot, 2 drops. 

Ointment of Red Oxide of Mercury, 4 drams. 

Benzoinated Lard, 1^2 ounces. 

Or:— 

Precipitated Sulphur, 1 dram. 

Salicylic Acid, 10 grains. 

Vaseline, 1 ounce. 

Apply directly to the hair, rubbing well into the scalp every night. 

Or:— 

Boroglycerin, 2 drams. 

Rose Water, 8 ounces. 

Apply every night, rubbing well into the scalp. 

Or:— 

Tincture of Cantharides, 3 drams. 

Tincture of Capsicum, 3 drams. 

Oil of Lemon, 1 dram. 

Castor Oil, 2 drams. 

Alcohol, 2 ounces. 

Spirits of Rosemary, . . , 1 ounce. 

Apply every night and morning, rubbing well into the scalp. 

BALDNESS OR ALOPECIA. 

The partial or complete loss of hair. 

Causes. — The disease may be inherited or acquired. If acquired, it 
occurs both in age and in early life. It may be a symptom of such other 
diseases as: syphilis, fevers, dandruff, itch, eczema, and parasitic skin 
diseases. 



DANDRUFF OR SEBORRHCEA. 305 

Prognosis. — The seriousness of the disease depends entirely upon the 
cause. When it proceeds from old age, the hair can never be restored. 
If from other causes which can be speedily and completely removed the 
probability of the return of the hair is considerable. 

Treatment. — This is to be adapted to the probable cause. 

If due to dandruff, the treatment of that condition should be followed. 

If due to anaemia (bloodlessness), general tonic treatment must be 
instituted. (See "Anaemia," page 439.) 

If due to syphilis, the treatment will be the treatment of that disease, 
and in all such cases a physician should be consulted. 

In all forms of baldness the following will be found of benefit : — 

Gallic Acid, 1 dram. 

Cologne Water, 2 drams. 

Tincture of Cantharides, 1 dram. 

Vaseline, 2 ounces. 

Mix and rub well into the scalp once daily. 

Or, the following may be used : — 
Mix well together — 

Liquor of Ammonia, 1 ounce. 

Camphorated Alcohol, iy> drams. 

Bay Salt, y 2 ounce. 

Water, , 1 pint. 

With this mixture bathe the head three times a day. Afterwards, 
rub well into the scalp a pomatum made of fresh lard, four parts, and 
camphor, one part. The action of the sedative water restores the 
capillary circulation which forms the bulb of the hair, and imparts new 
life to the organ. The pomatum assists and favors the growth. 

Or, use either of the following : — 

Castor Oil, iy 2 ounces. 

Tincture of Cantharides, y> ounce. 

Mix well together, and rub the bald part with it night and 
morning. 

Or, lard, made to a thin consistence with bay rum, rubbed in night 
and morning. 

One of the most successful remedies ever used is prepared as fol- 
lows : — 



306 DISEASES OF ADULTS. 

Glycerine, 4 ounces. 

Tannin, 1 dram. 

Tincture of Cantharides 2 drams. 

Oil of Capsicum,. . . 10 drops. 

Apply to the bald spots morning and evening. 



PARTIAL BALDNESS OR ALOPECIA AREATA. 

Patches or small areas of baldness on the scalp and beard. 

Causes. — In some cases this seems to be caused by a parasite; in 
others, by a disturbance of the nervous system. 

Symptoms. — The scalp, beard, and eyebrows are affected by one or 
more round, smooth, white patches or spots of baldness. These differ 
from the spots in ringworm by the absence of broken off hairs or of any 
signs of the follicles. There may be at first some redness of inflamma- 
tion, but the spots very soon turn white. They may appear gradually 
or suddenly. 

Prognosis. — Recovery is very slow ; faster in children than in adults. 
The older the person the more doubtful the recovery. When the hair 
does begin to return it appears as a fine, white down; after which the 
stronger natural hair follows. 

Treatment. — The tonic preparations recommended for baldness are 
very satisfactory ; as are also the local applications. 

The following tonic taken internally proves valuable in some cases : — 
Fluid Extract of Jaborandi, 1 ounce. 

Take 10 drops in water three times a day. 

For local applications follow the treatment for baldness as there given. 

NEURALGIC HEADACHE OR TIC DOULOUREUX. 

Sudden pain of a sharp and darting character. 

Causes. — Anaemia; cold; eye-strain; affections of the teeth; anxiety; 
mental exertion; rheumatism; syphilis; such tendency as occurs in 
families almost proves that it is heredity. 

Symptoms. — Sharp, lightning-like, shooting, stabbing pains, most 
common at points just above and below the eye; sometimes twitching of 
the muscles and pain along the course of the nerve. It is often most 
severe along the left side of the head and face, and is accompanied by 
a profuse flow of tears. 



SICK, BILIOUS, OR BLIND HEADACHE. 307 

Treatment. — Attention to the general health must be given during 
the intervals of the attack. Nutritious diet and treatment of the cause 
as directed in anaemia, rheumatism, malaria, etc., which see. 



MIGRAINE OR SICK HEADACHE, BILIOUS HEADACHE, 
OR BLIND HEADACHE. 

Pain in the head, limited more or less to one side of the head, with 
more or less disturbance and prostration. 

Causes. — Heredity; overwork; worry; anxiety; insufficient sleep; 
mental labor; eye-strain; dyspepsia; irritation of the ovaries or uterus; 
and many other undetermined causes. 

Prognosis. — Seldom permanently cured; but free from danger to 
life. Susceptibility to this form of headache increases with age. 

Symptoms. — Preceded for a day or two by digestive disturbance and 
feeling of weariness and exhaustion, and heaviness over the eyes. Sensa- 
tion of chilliness; nausea, sometimes vomiting; soreness in the muscles 
over the body ; sensitiveness to light ; pain of a sharp, shooting, pulsating 
character; face pale or flushed; pain on the left side, in front, on the 
temple, or at the back of the head; not often the pain is on the right 
side or on both sides. Moving, sound, and light become intolerable. 
These sensations of pain and discomfort are followed by intervals of 
rest and freedom from pain. 

Treatment. — The attack may sometimes be aborted by : — 

Antipyrine, 10 grains. 

Or:— 

Phenacetine, 10 grains. 

If due to eye trouble, a competent oculist should be consulted. For 
the attack, the following will be found of benefit : — 

Bromo-Caffeine ; a dessert-spoonful in half a glass of water every half 
hour for four or five doses, and 

Bismuth Subnitrate, 80 grains. 

Dilute Hydrocyanic Acid,. . 8 drops. 

Cinnamon Water, 1 ounce. 

Mix and take one teaspoonful every two hours until nausea and 
vomiting subside. 

If due to anaemia, see "Anaemia," page 439. If due to cold, warm 



308 DISEASES OF ADULTS. 

applications, hot drinks, a brisk cathartic, preferably a dose of salts, and 
the following to relieve pain: — 

Dover's Powder, 5 grains. 

Sweet Spirits of Niter, 15 drops. 

Every three hours until relieved. 

Or:— 

Antifebrine, 10 grains. 

Caffeine, 4 grains. 

Potassium Bromide, 4 grains. 

Divide into four powders. Take one every half hour until relieved. 

Or:— 

Phenacetine, 10 grains. 

Citrate of Caffeine, 5 grains. 

Monobromated Camphor, 20 grains. 

Make 10 such capsules and take one every two hours until relieved. 

Menthol pencils applied locally to the- seat of pain and the inhalation 
of camphor are often beneficial. 

The diet must be carefully watched during the interval, for indis- 
cretions in eating are often the direct cause of an attack. The use of 
tea, coffee, tobacco, and alcohol must be stopped or limited in quantity. 

When due to malaria, treat the cause. (See "Malaria," page 406.) 



RHEUMATIC HEADACHE. 

Pain in the back and front of the head. 

Causes. — Exposure to cold and draughts ; dampness ; lowered vitality ; 
heredity. 

Symptoms. — Pain in the back and front of the head ; distinguished 
from neuralgia by being on both sides of the head, made worse by moving 
the muscles, and by the absence of any point of especial tenderness. The 
pain is most often felt at night when the patient is warm in bed. The 
pains shoot from point to point and, when they follow the jaw downward, 
mastication causes intense pain. 

Treatment. — Use light diet and abstain from animal food; give 
attention to the clothing ; keep the body and feet warm and dry. When 
the pain is great, use hot fomentations or mustard plaster on the back of 
the neck, and give a gentle purgative at night. The following liniment 
is found very beneficial : — 



CONGESTIVE HEADACHE. 309 

Soap Liniment, 2^ ounces. 

Liquor Ammonia, y 2 dram. 

Laudanum, y 2 ounce. 

Mix and apply to the part. 

Or:— 

Oil of Wintergreen, \]/ 2 drams. 

Alcohol, 2 ounces. 

Rub thoroughly into the parts affected. 
Internally administer 

Sodium Salicylate, 10 to 15 grains 

Take in half a glass of water, every hour until relieved, or for six 
doses. 

CONGESTIVE HEADACHE. 

Cause. — This proceeds from a congested state of the vessels of the 
brain, an overfulness of blood or a weakness of the nerve forces, or from 
an excessive nervous irritability, which frequently affects circulation. 

Symptoms. — Whichever of these may be the cause, there is nearly 
always a dull pain over the whole of the head. When it arises from an 
overloaded condition of the vessels, there is usually a flushed countenance 
with bloodshot eyes and a flushed expression; we find, on inquiry, also 
a sluggish liver, congested brain, and a tendency to apoplexy or paralysis. 
A very effectual remedy for removing pain is : — 

Acetanilid, 3 to 5 grains. 

Or:— 

A tablet containing Acetanilid, Camphor, and Caffeine; known as 
Migraine Tablet. 

Or:— 

Bromide of Potash in 15 grain doses. 
Repeat only once after two hours. 

PERIODIC HEADACHE OR BROW ACHE, BROW AGUE, 

As it is variously called, is an intermitting pain, which comes on at 
periods more or less regular, and is confined to the brow. It will nearly 
always yield to full doses of quinine, especially if due to malaria. Fre- 
quently brow ache or frontal headache, as it is sometimes called, is due to 



3 io DISEASES OF ADULTS. 

constipation and prompt relief follows purgation with castor oil or 
Epsom salts. 

ORGANIC HEADACHE, 

Resulting from actual disease of the brain, is rare, and when it does 
occur, only a palliative mode of treatment can be adopted. Sedatives, 
such as opium and bromides, may, for a time, relieve the most intolerable 
anguish, but they will not touch the disease itself. 

Citric acid, or lemon juice, is often of great service in easing pain. 
Put a teaspoonful or two in a glass of cold water and drink it. 

THE HEADACHE OF NEURASTHENIA OR OF NERVOUS 

DEBILITY 

Is a very common type of headache in which the patient feels as 
though a constricting band were about the head, or experiences a sense 
of pressure on top of the head, or dull pain at nape of neck. It is usually 
most severe in the morning, disappearing as the day advances. For 
treatment, see Neurasthenia, page 426. 

HEADACHE OF EYE-STRAIN 

May be of the type described under Migraine, or it may take the form 
of pain all over the forehead and a sense of pressure at the nape of the 
neck. 

For treatment the patient should consult an oculist. 

ANAEMIC HEADACHE. 

This is due to an impoverished state of the blood. The pain may be 
felt immediately over each eyebrow with a sense of weight or pressure 
on top of the head and at the base of the brain. 

For treatment of this type, see Anaemia, page 439. 

HEADACHE DUE TO DISEASES OF THE KIDNEY. 

The pain may be felt anywhere in the head and may be of a shifting, 
pulsating, or wave-like character, and is accompanied by ringing in the 



RINGWORM OF THE SCALP OR TINEA TONSURANS. 311 

ears and dizziness. The complexion is doughy or pasty. Puffiness of 
the lower eyelids may be apparent. For this condition a physician should 
be consulted without delay. 

RINGWORM OF THE SCALP OR TINEA TONSURANS. 

A contagions disease of the scalp of a parasitic nature, in which bald 
spots ringed around with minute water blisters appear. 

Cause. — It is produced by a fungus or vegetable organism which is 
known as trichophyton. This burrows into the follicles of the hair and 
the skin of the scalp, and the disease is highly contagious. It may be con- 
tracted from ringworm in other parts of the body. It is almost wholly 
confined to young persons before the age of puberty. 

Symptoms. — It appears in small patches upon which minute water 
blisters form, and from which at a later period the skin or crusts peel or 
scale off. The hair becomes brittle in the parts affected and is broken off 
close to the skin, leaving a circumscribed area covered by a short stubby 
growth or a bald spot with very much the appearance of the flesh of a 
plucked fowl. The color of the parts involved becomes red or greenish 
yellow, and unless the disease is checked the skin becomes raised, puffy, 
and presents raw, inflamed points which discharge a sticky yellowish 
secretion. Itching is always a prominent symptom. 

Prognosis. — Without treatment it may persist for years, or until the 
age of puberty, when it seems to exhaust itself and to gradually subside. 
Even under treatment it is liable to recur up to that age. 

Treatment. — The hair should be cut close to the skin and the parts 
thoroughly cleansed with tincture of green soap and hot water. After 
drying well (the patient's towel should not be used by another until 
thoroughly boiled), the parts may be anointed with blue ointment once 
daily; or the following : — ■ 

Peruvian Balsam, ]A. ounce. 

Salicylic Acid, 20 grains. 

Resorcin, 20 grains. 

Vaseline, 3 ounces. 

Mix and apply twice daily. 

In addition the scalp should be rubbed every morning with the 
following : — 

Oil of Turpentine, 2 drams. 

Spirits of Camphor, 3 ounces. 

Ammonia Water, 1 dram. 



312 DISEASES OF ADULTS. 

On- 
Boric Acid, 20 grains. 

Flowers of Sulphur, 20 grains. 

Vaseline, 1 y 2 ounces. 

Mix and apply night and morning. 

Cases which do not yield to this treatment should then be treated 
with : — 

Caustic Potash, 9 grains. 

Carbolic Acid, 24 grains. 

Hydrous Wool-fat, y 2 ounce. 

Oil of Theobroma, y 2 ounce. 

Rub only a small amount of this into the scalp night and morning. 
It is better not to shave the parts when this is applied, as it is retained 
more completely by the hairs. 

Or:— 

Ointment of Boric Acid, 2 ounces. 

Ointment of Eucalyptol, 2 ounces. 

Oil of Cloves, y 2 dram. 

Glycerine, Sufficient to make an ointment. 

Rub well into the scalp night and morning. 



BARBER'S ITCH OR RINGWORM OF THE BEARD. 

A disease which affects the hairy portion of the face and neck in the 
adult male. The hair, follicles, and skin tissues are affected by a fungous 
growth so as to produce pustules or conical elevations. 

Cause. — It is produced by the same fungous growth (the trichophy- 
ton) as produces ringworm. It is usually contracted in barber shops 
from an unclean razor or brush. 

Symptoms. — It begins with one or more reddish scaly patches. They 
soon show little conical elevations, which mature at the top, and surround 
a single hair. They are at first of a pale yellowish color. After a few 
days they burst, and the matter, as it runs out, forms hard brownish 
crusts. The crusts fall off in a week or two, leaving purplish sluggish 
pimples behind, which are usually a long time in disappearing. 

Prognosis. — The disease is extremely chronic and is very likely to 
return unless completely cured. 

Treatment. — Soak the crusts of the pustules with olive oil or almond 
oil to soften them. Then wash them with green soap and water and 



GRANULAR LIDS OR TRACHOMA. 313 

remove them. The face is then carefully and fully shaved. This will be 
a painful operation the first time. The face is then bathed in water as 
hot as can be borne. Each mature pustule is opened with a fine needle. 
Sponge the face and neck with the following wash : — 

Hyposulphite of Soda, 1 dram. 

Water, 1 ounce. 

The face is again washed in hot water and thoroughly dried. Anoint 
the face with the following ointment : — 

Sulphur Ointment, 1 y 2 drams to the ounce. 

Allow this ointment to remain on the parts all night. In the morning 
wash off the ointment thoroughly with soap and water. Then apply the 
solution of hyposulphite of soda and dust on an ordinary face powder. 
Treat the face in this way every night and morning, shaving when the 
beard is long enough. The razor must be in good condition. The 
contagious nature of the disease must be remembered and all possible 
cleanliness observed. 



DISEASES OF THE EYES. 
GRANULAR LIDS OR TRACHOMA. 

An infectious inflammation of the mucous membrane covering the 
inner surface of the eyelid (the conjunctiva). 

Causes. — It is probably caused by a germ, the growth of which is 
encouraged by uncleanliness. 

Symptoms. — The mucous membrane is covered with small granula- 
tions (minute rounded bodies like grain). These are at first quite 
distinct, but, as the disease progresses, they run together forming hard 
masses which irritate the eyeball and cause inflammation and ulceration. 
There is redness and swelling of the mucous membrane and a flow of 
matter which causes the lids to stick together. There is the sensation 
of the presence of a foreign body in the eye; more or less severe pain; 
sensitiveness to light ; and copious flow of tears. 

Prognosis. — The disease is very serious, as it often causes loss of 
sight or necessitates prolonged treatment. 

Treatment. — Cleanliness and reduction of the swelling and inflam- 
mation are the ends sought in the treatment. If only one eye is infected 



314 DISEASES OE ADULTS. 

the patient must use all possible precautions to prevent the disease spread- 
ing to the other. Other persons may also contract the disease from him. 
So the greatest care in the matter of towels, etc., must be enjoined. 
Bathe the eyes frequently with hot boric acid solution (a teaspoonful of 
boric acid to a pint of water), invert the lid and gently rub it with a 
smooth piece of dry sulphate of copper. The lid should be kept open 
after the application until the eyeball is syringed with warm water, to 
remove from it any of the solution caused by the flow of tears acting on 
the sulphate. There will probably be great smarting of the eye, and 
increased redness of the white portion, which must be suffered to subside 
before the application is repeated. 

Or the following excellent ointment may be used : — 

Sulphate of Copper, 8 grains. 

Salicylic Acid, 8 grains. 

Cocaine Muriate, 8 grains. 

Vaseline, io drams. 

Mix, and rub into the inverted eyelid three times daily. 

STYE OR HORDEOLUM. 

A suppurating inflammation of the glands of the eyelid. 

Causes. — A stye is frequently associated with a condition of debility. 
Scrofulous and anaemic young people are very subject to this disease. 
Blepharitis, inflammation of the eyelids, may cause a stye by reason of 
the uncleanly accumulation of scales and crusts which become favorable 
sites for germs. 

Symptoms. — Swelling and redness occur over the gland for a few 
days, then a red pimple appears which itches intensely and soon fills with 
matter. 

Prognosis. — An internal stye is more painful and of longer duration 
than an external stye. The course, however, is short. More than one 
stye may be present at the same time. 

Treatment. — The following ointment, if used early, will abort 
styes : — 

Red Oxide of Mercury, 4 grains. 

Olive Oil, 4 drops. 

Vaseline, Yz ounce. 

Mix and rub in twice daily. 

If the stye is fully formed a few of the winkers should be pulled out 



WATERY EYE. 315 

to allow the pus to escape and the lids should be bathed frequently with 
very hot boracic acid solution (one teaspoonful to a pint of hot water). 
Peroxide of hydrogen, full strength, may be applied on a piece of 
absorbent cotton. After having thus cleaned the lid, the above ointment 
should be used. As the condition is frequently associated with debility 
the treatment laid down for anaemia should be employed. (See Anaemia, 
page 439.) 

WATERY EYE. 

If we look closely at the inner corner of the eyelids, we may perceive 
a little point at each, which is the opening of a duct that runs into the 
nose. These openings convey the tears from the eye ; every time the eye 
is shut in winking the fluid is forced into those pipes. Now, when either 
or both become so thickened as to be stopped up, the tears, of necessity, 
fall over the cheek ; this is called a watery eye. 

Cause. — Usually caused by taking cold. 

Treatment. — As the cause of this disease is most commonly inflam- 
mation, it may be relieved in its early stages by a plan directed toward 
the lessening of that inflammation, and the best is as follows : — 

Pure Water, 2 ounces. 

Sulphate of Zinc, 4 grains. 

Laudanum, y 2 dram. 

Mix and apply frequently. Cold must be strictly avoided. If the 
trouble does not yield to this remedy consult a physician or oculist. 

BLEAR EYE. 

A term given to an inflammatory appearance of the eyelids and corner 
of the eye itself. 

Causes. — Advancing age, cold, or temporary weakness. It is also 
caused by hereditary taint, and resolves itself into a constitutional defect. 
Treatment. — Where it is not constitutional, use the following 
lotion : — 

Sulphate of Zinc, 5 grains. 

Water, 2 tablespoonf uls. 

Mix. Moisten the eye frequently with a linen cloth. 
Another good remedy is to take an active aperient of calomel and 
rhubarb, and to bathe the eye with poppy-water. If the eye should feel 



3 i6 DISEASES OF ADULTS. 

weak after the inflammation has subsided, bathe it frequently during the 
day with a lotion composed of sugar of lead, one grain, to a large table- 
spoonful of water. 

WEAKNESS OF THE EYES. 

These excellent washes for ordinary weakness of the eyes will prove 
very beneficial : — 

Sulphate of Copper, 15 grains. 

Camphor, 4 grains. 

Boiling Water, 4 ounces. 

Mix, strain, and when cold make up to four pints with water. Bathe 
the eye night and morning with a portion of the mixture. 

Or the following : — 

Spirit of Mindererus. 1 ounce. 

Rose Water, 7 ounces. 

Mix and use as an eye-wash occasionally. 

Or this : — 

White Vitriol, 10 grains. 

Elder Flower Water, 8 ounces. 

Mix and apply as occasion may demand. 

INFLAMMATION OF THE EYE OR CONJUNCTIVITIS. 

Inflammation of the mucous membrane which covers the front portion 
of the ball of the eye and also lines the lids and margins of the latter. 
It varies in severity according to the extent of the part involved. 

Causes. — The most common cause is exposure to cold. The disease 
appears to be epidemic in the spring of the year, and there is every 
indication that it is of infectious origin by bacilli. 

Symptoms. — In the simpler form, known popularly as "pink-eye," 
there is redness, smarting, and sensitiveness to light. There is also the 
sensation of a foreign body in the eye, which is probably due to the 
accumulation of mucus into strings. Burning and itching of the lids 
are present. The secretions which accumulate on the lids during the 
night dry and glue the lids together. 

Treatment. — Simple cases are to be bathed with warm water or in : — 

Boric Acid, 1 teaspoonful. 

Warm Water, 1 pint. 



GOXORRHCEAL INFLAMMATION OF THE EYE. 317 

Bathe the eyes with this every two hours. 

Severe cases with discharge of mucus and pus, swollen membrane 
of the eyelids and eyeball, sometimes subside in from three to ten days 
under the treatment given above. 



GONORRHOEAL INFLAMMATION OF THE EYE. 

A form of conjunctivitis due to the presence of the germ of gonor- 
rhoea, the gonococcus. 

Cause. — The presence of the gonococcus, the germ of infection of 
gonorrhoea. 

Symptoms. — The lids are swollen, red, and stuck together with a 
thick, creamy, or greenish-yellow discharge, which escapes from the lids 
and runs down on the face. There is much pain and heat until the 
discharge flows freely. The disease occurs in newborn children through 
infection from the vaginal cavity in birth. 

Prognosis. — The severity depends on the general health of the patient 
and the extent to which the cornea is involved. The great danger is 
perforation of the cornea and loss of sight. The eye is very subject to 
complications even after an apparent recovery from the attack. 

Treatment. — The disease is too severe and dangerous to permit of 
any but professional attention. There is, however, the greatest need of 
cleanliness and all means to prevent contagion. The saturated solution 
of boric acid, previously mentioned, will be very helpful in keeping the 
eye free from the discharge and in allaying the inflammation. Every 
effort must be made to prevent contagion to the other eye if only one 
is involved. 



ABORTED STYE OR CHALAZION. 

A tumor of the eyelids resulting from retained secretion in the gland. 

Cause. — Infection of the glands of the eyelids. 

Symptoms. — A small growth about one eighth of an inch from the 
edge of the lid. It is marked by absence of pain and causes no incon- 
venience. There may be a single tumor or several together. They do 
not inflame or suppurate as true styes do. 

If small they may remain; but, if large, they may cause irritation 
by friction in winking. 



318 DISEASES OF ADULTS. 

Treatment. — Small chalazia call for no treatment; large ones are cut 
into and the contents removed. 



INFLAMMATION OF THE EDGE OF THE EYELIDS OR 

BLEPHARITIS. 

Inflammation of the follicles or ducts along the margin of the lid. 

Causes. — Xeglect of cleanliness ; exposure to irritating agencies, dust, 
heat, winds; anaemia; scrofula; eruptive fevers; and overflow of tears. 

Symptoms. — Redness of the lids and crusts at the root of the eve- 
lashes caused by dried secretions. 

Prognosis. — The lashes which fall or are pulled out during this 
disease will grow in again in the form of the disease known as Blepharitis 
squamosa, but in Blepharitis ulcerosa they do not return. Chronic 
catarrhal conjunctivitis, a stye, loss of the lashes, and overflow of tears 
may result. 

Treatment. — Strict cleanliness ; bathe parts with solution of boric 
acid (one teaspoonful to a pint of hot water). After having removed the 
crusts in this way, the following ointment should be rubbed well into the 
edge of the lid each night on retiring : — 

Yellow Oxide of Mercury 4 grains. 

Vaseline, 1 ounce. 

Or:— 

A little red precipitate ointment rubbed into the roots of the lashes, 
when the lids are closed on retiring to rest. This may be repeated every 
night until no longer required. 

Sometimes the hairs on the lids grow inward and cause great irritation 
of the balls. Collodion brushed over the lids will, as it dries, cause 
contraction of the skin and so draw the hairs outward, but this is only a 
temporary relief, and the application must be frequently repeated. 
Surgical aid must be sought. 

CATARACTS. 

An opacity of the lens of the eye or of its capsule or of both. 
Cataracts are either partial or complete, and either stationary or pro- 
gressive. As to their origin they are classified as : Congenital or 
inherited; Infantile, the result of rickets; Senile, due to old age; Diabetic, 
accompanying diabetes; Traumatic, the result of injury: Complicated, 



EYE BRUISES OR BLACK EYE. 319 

due to disease in other parts of the eye ; and Secondary, when they return 
after operation. They are also closely classified according to location 
or to the part affected. There is also a division into Hard and Soft 
cataracts. 

Causes. — The name cataract was given to the disease under the 
impression that some semi-solid matter was exuded from the eye and 
fell down over the parts in the form of a waterfall. The causes, so far 
as known, are indicated in the names given to the several forms. Senile 
cataract is caused by an actual change which old age brings about in 
the eye. Diabetic cataract is the result of that disease. Traumatic 
cataracts are caused by an injury to the eye. These injuries are of 
various sorts and natures : blows, stroke of lightning, wounds of the eye 
tissues, and the entrance of foreign bodies. Infantile cataract seems to 
be the result of malnutrition in rickets. The time of development of a 
cataract varies from a few hours to twenty years. In some cases the 
changes are so slow that they seem to be stationary. 

Treatment. — The removal of the growth is the only relief when there 
is danger of loss of sight. This operation is either by cutting or plucking 
the growth out. It is usually successful. 

EYE BRUISES OR BLACK EYE. 

Causes. — A contused wound caused by some injuring agency such as 
the fist, or by coming in violent contact with some object, is attended by 
the rupture of vessels and the escape of blood into the loose cellular tissue 
of the eyelids. The swelling is sometimes very marked and may be 
sufficient to completely close the eye. The tissues are at first stained a 
reddish purple color, changing as the swelling subsides to a darker green- 
ish hue, through yellow to the natural tint as recovery takes place. 
Sometimes suppuration takes place and the bruised tissue has to be 
opened and dressed with strict antiseptic care. 

Treatment. — The following lotion will quickly promote resolution : — 

Dilute Acetic Acid, 5 ounces. 

Tincture of Arnica, 1 ounce. 

Ammonium Chloride, 1 ounce. 

Boiled or Distilled Water, 5 ounces. 

Mix and apply locally by means of compresses wet with this solution. 

The reduction of the swelling and prevention of the discoloration 
may be accomplished by immediate and constant use of either hot or cold 
applications. 



320 DISEASES OF ADULTS. 

PROTRUSION OF THE EYEBALL OR EXOPHTHALMOS. 

Causes. — This may result from a variety of causes. One or both 
eyes may be protruded from hemorrhage within the orbital cavity. 
Tumors, cancer, outgrowths of bone and enlargement of the lachrymal 
glands may cause the eye to bulge outward. The most common cause, 
however, is a disease of the nervous system associated with enlarged 
thyroid gland (goitre). This condition is known as exophthalmic goitre 
or Graves' disease. 



SINKING OF THE EYEBALL. 

Causes. — One or both eyes may sink into the orbital cavity by reason 
of absorption of the fatty tissue behind the eyeball. This occurs in 
certain wasting diseases, fevers, and imperfect circulation of blood in the 
vicinity of the eye. 

Treatment. — The treatment of this condition is that of its cause, but 
in general it may be stated that rest and nutritious diet combined with 
such medicinal treatment as quinine, strychnine, iron, arsenic, etc., will 
be of great benefit. These remedies may be administered in the form 
of pill or capsule as follows : — 

Strychnine Sulphate, Yi grain. 

Iron Arsenate, 2 grains. 

Quinine, 24 grains. 

Extract of Licorice, 24 grains. 

Mix and make into twenty-four pills or capsules and take one after 
each meal. 



SQUINT OR STRABISMUS. 

A deviation of one of the eyes from the right direction so that both 
of the eyes are not directed towards the same object at the same time. 

The varying amount and direction of this deviation from the proper 
direction gives rise to several sorts of squint. They are classified as 
follows : — 

Paralytic Squint is due to the paralysis of the muscles which control 
the movement of the eye. 



SQUINT OR STRABISMUS. 321 

Spastic Squint is that form which is produced by spasms or sudden 
contractions of the muscles of the eye. 

Constant Squint is that form which is always noticeable. 

Periodic Squint is noticeable only at times such as when looking at 
near-by objects. 

Intermittent Squint occurs at more or less regular intervals. 

Unilateral Squint affects but one eye. 

Alternating Squint affects both eyes alternately. 

Convergent Squint is the turning of one eye inwards towards the 
nose. 

Divergent Squint is the outward turning of the eye towards the 
temple. 

Treatment. — This is adapted to the cause and consists of correcting 
the refraction of the eye by the use of proper mechanical devices; by 
absorbents and other medicinal agents in cases of paralysis and of spasms ; 
and by a surgical operation. The operation is called both strabotomy 
and tenotomy. It consists of cutting the muscles which control the 
movements of the eyes so as to secure uniformity of motion. This is 
not performed in the case of children until they are six years old. This 
is the age at which they begin to use the eyes in school and in near work. 
Prior to that age the treatment is corrective and preparatory to the 
operation. 

If the sight of both eyes is equally good, all of the objects are seen 
double ; but if the sight of one is much better than that of the other, the 
mind attends to only the clearer impression and disregards the other. 
This disregard may lead to dimness of vision (amblyopia) in that eye. 
To correct this, or to prevent it, a bandage is worn in childhood over the 
stronger eye to enforce the use and development of the latter. It is 
customary to operate on the poorer eye first, and, after this has improved, 
the stronger eye is then treated. This method gives the patient the use 
of one eye nearly all of the time. As it is a matter of nice adjustment, 
sometimes a second operation is necessary. 

The treatment of strabismus due to paralysis of the muscles of the 
eye will depend upon the cause. If it is caused by rheumatism it will 
respond to the treatment of that disease by salicylates and diaphoretics 
(medicines which produce perspiration). Consumption, diphtheria, dis- 
eases of the base of the brain, diabetes, injuries, and exposure to cold 
are among the other causes of this form. The trouble usually responds 
sooner or later to the successful treatment of the disease. 



322 DISEASES OF ADULTS. 

DISEASES OF THE EAR. 

EARACHE OR OTALGIA. 

Causes. — This may be of neuralgic origin, or it may be due to acute 
or chronic inflammation of the middle ear, a condition which frequently 
complicates scarlet fever, measles, diphtheria, tonsilitis, and influenza. It 
is often brought on by exposure to colds or draughts. It is not uncom- 
mon during the period of teething in children and is especially severe 
while cutting their permanent teeth. Grown persons sometimes suffer 
from it while cutting their wisdom teeth. There is not often much con- 
stitutional derangement, though the pain may be sufficiently severe to 
render the patient unable to attend to his daily affairs. 

Treatment. — When of neuralgic origin, the following will be helpful 
in relieving pain : — 

Tincture of Belladonna, 2 drams. 

Laudanum, 2 drams. 

Mix and put five drops in the ear several times a day. 
Or:— 

Chloroform, 3 drops. 

Expressed Oil of Almonds, 4 drams. 

Mix, warm, and fill the ear canal ; hold until it feels warm, when the 
ear should be syringed with warm water. 

When due to inflammation, the ear should be syringed and cleansed 
with peroxide of hydrogen, one part, and warm water, three parts. 
Then a piece of cotton saturated in this solution should be placed in the 
ear canal. 

The ear may be syringed continuously with several quarts of very hot 
salt solution (one teaspoonful of table salt to a pint of hot water), and 
great relief experienced. 

When earache is caused by an abscess, and is attended with much 
swelling and severe pain, hot fomentations may be used, syringing the 
external passage with warm water; and, after the abscess has discharged, 
syringe with a solution of sulphate of zinc, in the proportion of eight 
grains to the ounce of plain or rose water, attention being paid to the 
bowels. Sometimes the drum must be punctured to allow the escape of 
pus. With some persons any derangement of the general health will 
cause the formation of these abscesses, and in such cases the treatment 
must be general rather than local. Earache, no doubt, often proceeds 



INFLAMMATION OF THE EAR OR OTITIS. 323 

from derangement of the digestive organs, and may be relieved by 
active purgatives and emetics. 

When a tonic is required, the following will be found very good : — 

Citrate of Iron, 1 dram. 

Strychnine, 1 grain. 

Syrup of Orange Peel, 2 ounces. 

Soft Water, y 2 pint. 

Mix. Dose, one teaspoonful three times a day. 

In children, during dentition, lancing the swollen gums will often 
afford relief, especially if an aperient be given, such as rhubarb and 
magnesia combined with a little ginger. Older children may have three 
or four drops of warm olive or almond oil, with one or two drops of 
laudanum dropped into the ear; and take compound senna mixture, 
repeated until the bowels are freely opened. Should these remedies not 
prove effectual, a fomentation of camomiles and poppies should be 
applied. The heart of a roasted onion applied warm to the external 
orifice will sometimes afford relief. If the case is very obstinate, two or 
three leeches behind the ear may be tried, with the following anodyne 
saline aperient : — 

Acetate of Morphine, ]/ 2 grain. 

Solution of Acetate of Ammonia, 3 ounces. 

Sulphate of Magnesia, 1 ounce. 

Water of Camphor Mixture, 5 ounces. 

Mix, and take two tablespoonfuls every four hours. 

INFLAMMATION OF THE EAR OR OTITIS. 

This is characterized by an acute and increasing pain, with tender- 
ness on pressure or moving the jaw, accompanied by fever. Sometimes 
the external ear is the seat of the disease, sometimes the internal, or both 
may be involved. There is frequently impaired or confused hearing, and 
often the pain is so acute as to produce delirium. On examination, the 
meatus is observed to be more or less red, swollen, tender, and dry. 
After a time, if the disease progresses, suppuration takes place, and pus is 
discharged. If this happens in the inner ear, frequently the tympanum 
ulcerates and bursts, unless such injury is prevented by timely aid of a 
surgeon. If this disease is neglected it may result in loss of hearing. 
An obstinate discharge may remain after the other symptoms have 
disappeared. 



324 DISEASES OF ADULTS. 

Causes. — It is usually caused by cold, or exposure to currents of cold 
air; injudicious bathing; violent syringing or probing; scrofula; and 
acute diseases like scarlet fever. 

Treatment. — It is to be treated with fomentations, and the repeated 
application of leeches. At the same time active purgatives are to be 
administered. The ear should also be frequently syringed with warm 
water, and dusted with pulverized boric acid. 

Or:— 

The ear may be syringed twice daily with creoline solution (a tea- 
spoonful of creoline to a quart of water) and, after drying, this powder 
blown into the ear canal : — 

Salicylic Acid, 8 grains. 

Powdered Boric Acid, 4 drams. 

On- 
After syringing wtih the creoline solution, five to ten drops of the 
following may be allowed to run into the ear : — 

Ichthyol, 2 drams. 

Boiled or Distilled Water 2 drams. 

Glycerine, 2 drams. 

Tonic treatment internally will be of service such as, cod liver oil, 
syrup of hypophosphites, or syrup of the iodine of iron. The last is 
given in doses of from 1 5 to 30 drops in water three times daily. 

If there is any catarrhal disease of the nose or throat the same should 
be treated as advised under Xasal Catarrh, page 329. 

For chronic cases the following is highly recommended : — 

Cleanse the ear thoroughly by syringing with hot water ; dry well and 
paint on lightly : — : 

Carbolic Acid Crystals, 15 to 75 grains. 

Pure Glycerine, 2^ drams. 

When the discharge lessens the following application is to be used : — 

Pure Glycerine, 2^ drams. 

Mercury Perchloride, 3 grains. 



ECZEMA OF THE EAR OR TETTER. 

Symptoms. — An inflammation of the skin around or within the 
mouth of the ear canal accompanied by more or less itching and a watery 
discharge with the formation of crusts, or small scales. 



WAX IN THE EAR. 325 

Treatment. — The treatment of the condition is as follows : — 

Vaseline, 2^ drams. 

Oil of Cade, 15 drops. 

Or:— 

Vaseline, 5 drams. 

Starch, 2 y 2 drams. 

Zinc Oxide, 2j^ drams. 

Salicylic Acid, J 1 /? grains. 

Wet applications should not be employed under any circumstances. 

WAX IN THE EAR. 

Symptoms. — When this substance becomes too hard or abundant, 
there will be cracking or hissing noises in the ear, and generally deafness 
to a considerable extent. 

Treatment. — In this case the ear should be syringed with warm soap- 
suds. If this does not soften the wax put two or three drops of glycerine 
in the ear at night and syringe again in the morning. Repeat until the 
wax is removed. 

Or:— 

Fill the canal with olive oil. After an hour or so syringe with warm 
water. 

Then the ear may be cleansed with solution of peroxide of hydrogen, 
one part to three of water. 

FOREIGN BODIES IN THE EAR. 

First: Insects occasionally make their way into the external ear, 
particularly of children, when lying on the grass. They sometimes pro- 
duce horrible torture by irritating the drum of the ear. 

Second : A disease that may be acute or chronic is due to the presence 
of vegetable parasites which, acting as foreign bodies in the ear, cause 
considerable itching, pain, vertigo (dizziness), and deafness. 

These parasites appear as yellowish or black spots on the walls of the 
ear canal. 

Treatment. — To Remove Insects: Let the child recline with the 
opposite ear upon a pillow, and fill the affected one with sweet oil. There 
is no insect that will not perish, or make good its retreat, when this 
method is pursued. 



326 DISEASES OF ADULTS. 

Solid substances are frequently pushed into the ear by children, where, 
if large, they sometimes occasion much inflammation and become firmly 
wedged by the swelling. Great danger of destruction to the drum and 
small bones of the ear results from awkward attempts at removing such 
substances, by which they are driven still deeper into the canal. If the 
foreign body have any visible projecting point, of which a firm hold can 
be taken, this may be seized by forceps, or pincers, and the body removed 
directly; but'when the substance is rounded, or formed with many faces, 
or extremely smooth and cylindrical, it is very wrong even to attempt 
its removal by any such means. Cherry stones, apple seeds, common 
beads, garnets, bugle beads, and pieces of red coral, furnish many cases 
in point. 

If we attempt to seize them in front, they instantly slip farther in, 
and endanger the drum. We must get behind them and hook them out, 
always with great caution. Sudden and severe pain warns us when we 
touch the drum of the ear, and then all considerable pressure inward must 
cease. When the foreign body is small in proportion to the size of the 
canal, it may generally be removed by means of the little steel ear-picker 
on the handle of the common pocket tweezers ; but, when larger, the eye 
of a fine bodkin, or silver probe, should be gently curved and inserted 
beyond the body to draw it forward. A few drops of sweet oil, pre- 
viously dropped into the ear, will very much facilitate the operation. 

As children sometimes fancy things have got into the ear when they 
really have not, it is best to institute an examination before attempting 
their removal. This may be done by drawing the upper lobe of the ear 
upward and backward, which will have the effect of straightening the 
curved passage so that the eye can discern the drum at the bottom, unless 
there is an interposing object. 

To Remove Vegetable Parasites : Syringe the ear with warm water, 
after which fill the canal with alcohol and dry thoroughly. This treat- 
ment should be continued every two or three days until the growth 
disappears. 

POLYPUS OF THE EAR. 

Polypus of the ear is by no means an uncommon form of the fungoid 
growth, which sometimes occurs in several of the internal tissues. 

Symptoms. — It is of a jelly-like consistency, and a whitish yellow 
color, and is attached to the membranous lining of the ear. There are 



NOISES IN THE EAR. 327 

also granulations of fungus which sometimes shoot up from the mem- 
brane, and are distinguished by their reddish hue from polypi. 

Treatment. — These may generally be removed by being held firmly 
with a pair of forceps, and then gently twisted and pulled at the same 
time. This should only be done by a properly qualified person, as much 
mischief may result from the unskillful application of the forceps to so 
delicate a part. Sometimes, when the polypus is in the external passage, 
and not far up, it may be destroyed by application of chromic acid, or 
burnt alum, applied with a camel's-hair brush. 



NOISES IN THE EAR. 

Noises in the ear, like the distant sound of bells, roaring of the sea, 
hissing, singing, etc., are often indicative of a determination of blood to 
the head. With some, mere derangement of the digestive organs will 
cause these noises. When accompanied by a certain degree of deafness, 
they are generally occasioned by an accumulation of wax in the external 
passage, or a partial stoppage of the Eustachian tube by cold. When the 
noises become chronic, or long continued, bathing the head regularly 
every morning with cold water will sometimes remove them. If cold be 
the cause, or disordered stomach, they will pass away with the temporary 
ailments which occasioned them. 



DISEASES OF THE NOSE. 



COLD IN THE HEAD OR CORYZA 

Is an inflammation of the lining membrane of the nose and cavities in 
the head which communicate with the nose. It is attended by a sense of 
fullness in the head, sneezing and a discharge which at first is watery, 
later is mixed with mucus, which eventually becomes thick and yellowish. 

Causes. — Exposure to cold, dampness, and irritating vapors. 

Symptoms. — The attack is usually preceded by feeling of general 
malaise (tired feeling), and some brow ache; chilliness and fever; sneez- 
ing and a watery discharge from the nose. The catarrhal inflammation 
causes the tear tube to be stopped up so that the tears flow over the cheeks 
and the eyes become red and watery. If the inflammation extends into 



328 DISEASES OF ADULTS. 

the Eustachian tube, which communicates from the throat to the ear, there 
may be more or less deafness. If the condition involves the throat there 
may be some cough. The condition usually lasts from one to two or 
three weeks. 

Treatment. — A hot mustard foot-bath, hot drinks such as hot lemon- 
ade, ginger tea or plain tea with cayenne pepper, a prompt purge, prefer- 
ably Epsom salts, Dover's powders in 4 to 8 grain doses every two or 
three hours to cause sweating and dry up the secretion, and the follow- 
ing inhalation: — 

Compound Tincture of Benzoin, 1 ounce. 

A teaspoonful of the tincture to a pint of boiling water, and inhale 
through a paper cone every half hour until the fullness in the head is 
relieved. 

Or the following powder snuffed into the nostrils three times daily is 
of benefit : — 

Sulphate of Quinine, 8 grains. 

Salicylate of Bismuth, 8 grains. 

Boric Acid, 15 grains. 

Powdered Starch, 3 drams. 

Or:— 

Menthol, 7 grains. 

Boric Acid, . • • • • 5 drams. 

Vaseline, 3 J4 ounces. 

Mix and apply as an ointment to the nostrils two or three times daily. 

CHRONIC NASAL CATARRH. 

A chronic inflammation of the lining membrane of the nose associated 
with dropping of mucus into the throat with impairment of sense of 
smell and hearing. 

Causes. — May follow cold in the head when the same has been of 
frequent occurrence ; breathing irritating dust and vapors ; syphilis ; and 
scrofula. 

Symptoms. — Sense of fullness and swelling in the nose, swelling of 
the soft palate, dropping of mucus into the throat. The patient awakens 
in the morning with a plug of mucus in the throat which is dislodged 
by hawking and coughing. The voice has a peculiar nasal twang; brow 
ache is quite common; and there may be disagreeable sense of smell in 
the nose more or less constant. If the tear ducts are closed, the tears 
flow over the cheeks. 



INFLAMED AND ULCERATED NOSE. 329 

A cure is seldom effected except by change to a warmer and dryer 
climate. 

Treatment. — The nasal cavities should be syringed or sprayed with 
a solution made by dissolving one Setter's tablet in two ounces of warm 
water. This solution should be made fresh each time used. After hav- 
ing cleansed the nasal cavities with this solution or with glyco-thymoline, 
one part to three parts warm water, the following oil should be used 
in an oil atomizer : — 

Menthol, 8 grains. 

Camphor, 5 grains. 

Olive Oil, 1 ounce. . 

DobelPs cleansing solution is composed of : — 

Carbolic Acid, 1 grain. 

Bicarbonate of Soda, 5 grains. 

Biborate of Soda, 5 grains. 

Glycerine, 1 dram. 

Water, 1 ounce. 

Spray this into the nostrils. 

After these cleansing solutions one of these snuffs may be used : — ■ 

Boric Acid, 30 grains. 

Subnitrate of Bismuth, 2 drams. 

Hydrochlorate of Morphine, 1 grain. 

Or:— 

Powdered Bloodroot, 1 dram. 

Tannic Acid, 5 grains. 

Powdered Camphor, 1 dram. 

Subnitrate of Bismuth, 2 drams. 

Use either of the above as snuff every three hours. 
The following is a very agreeable application : — 

Tincture of Benzoin, 4 drams. 

Tincture of Guaiacum, 1 dram. 

Chloroform, 10 minims. 

Tincture of Myrrh, ]/ 2 dram. 

Oil of Almonds, 5 minims. 

Apply a few drops to each nostril once a day with a camel's-hair brush. 



INFLAMED AND ULCERATED NOSE. 

When the lining membrane of the nose is inflamed and ulcerated, a 
solution of carbonate of soda in warm water thrown up by a syringe will 



330 DISEASES OF ADULTS. 

be of service. If the purulent discharge be offensive, a few drops of the 
solution of chloride of soda or lime should be added to this. 



NOSEBLEED OR EPISTAXIS. 

Persons of a sanguine temperament and full habit of body are often 
subject to this disease. It ought to be regarded as beneficial, unless 
from a fullness of the veins and a tendency of blood to the head, are often 
excessive. Those who are troubled with vertigo and headache, arising 
relieved by bleeding from the nose ; and there can be no doubt that many 
a fit of apoplexy has been averted by it, and many an attack of inflamma- 
tory fever, or congestion of the brain, thus relieved. 

It is sometimes due to injury as from direct violence. 

Causes. — Violent exercise, great heat, blows on the nose, the long 
continuance of a stooping posture, and disease of the vessels conveying 
blood to the brain which renders them liable to rupture. It may come on 
without any previous warning, or be preceded by headache and a sense 
of heaviness, singing noises in the ears, heat and itching of the nostrils, 
throbbing of the temporal artery, and accelerated pulse. 

It may be due to presence of polypus ; chronic nasal catarrh ; disease of 
the nasal bones ; or the presence of a foreign body in the nose ; disease of 
the heart; mountain climbing. It is also one of the early symptoms of 
typhoid fever. 

Treatment. — When it comes on frequently and continues long, so as 
to cause faintness, and especially if the person subject to it be weak or 
advanced in years, it should be stopped as soon as possible. This may 
sometimes be effected by immersing the head in cold water, free exposure 
to cool air, and drinking cool acidulous liquids. The body of the patient 
should maintain an erect position, with the head thrown somewhat back, 
a cold piece of metal or ice applied to the neck over the spinal cord, 
vinegar or lemon juice snuffed up the nostrils, or an astringent wash 
injected into them with a syringe. It may be composed as follows : — 

Alum, 2 drams. 

Acetic Acid, 2 drams. 

Water, 6 ounces. 

Or, three drams of the tincture of chloride of iron in the same quantity 
of water. Or, if these fail, the nostrils may be plugged with lint dipped 
in a strong solution of the sulphate of copper. When the bleeding has 



POLYPUS OF THE NOSE. 331 

stopped there should be no haste to remove the clotted blood from the 
nostrils. Do not blow the nose violently, nor take stimulants, unless 
there be excessive faintness, in which case a little cold brandy and water 
may be taken. When there is a full habit of body, cooling medicines and 
light diet may be safely advised. 

A hot foot-bath to draw the blood to the lower extremities and ice 
applied to the nose are beneficial, or the following powder blown up the 
nostrils is a very certain remedy: — 

Tannic Acid, 20 grains. 

Antipyrine, 20 grains. 

Powdered Starch, 20 grains. 



POLYPUS OF THE NOSE. 

Polypus is a name given to a tumor generally occurring in me nose, 
but sometimes in the womb, or the ear, and so named from an erroneous 
idea that it had many roots or feet. It is the result of an excessive 
growth of the mucous membrane, and sometimes assumes a malignant 
character. It may be either of a soft texture so as easily to tear and 
bleed, or firm and fibrous, or even almost cartilaginous. The color is 
commonly a yellowish gray, and it has little or no sensibility, although it 
causes much pain by its pressure upon the surrounding parts, stoppage 
of secretions, etc. It is attached to the surface from which it springs by a 
narrow neck like a footstalk. When in the nose it interferes with the 
breathing, so that the patient sleeps with the mouth open. In this 
situation it may be destroyed by the use of such applications as chromic 
acid applied with a camel's-hair brush, or a little burnt alum taken like 
snuff, but the only safe treatment is the removal and for this a nose and 
throat specialist should be consulted. 

FOREIGN SUBSTANCES IN THE NOSE. 

Sometimes foreign bodies, such as pieces of tobacco pipe, etc., get 
pushed up the nose by children. If this is a bean, or anything which 
swells by absorption of moisture, the extraction is a matter of great 
difficulty. This should not be attempted by other than a professional sur- 
geon ; yet if the assistance of such cannot be readily obtained, the effort 
may be made by means of the fiat end of a probe or a silver bodkin, bent 



332 DISEASES OF ADULTS. 

in about the eighth of an inch at the end, and the instrument then 
introduced and passed beyond the object, so as to draw it out as with a 
hook, when the foreign body has not penetrated far. If the opposite 
nostril is closed, and the child is made to blow the nose violently, it may 
sometimes be driven out. 



COLD SORE, FEVER SORE, OR HERPES LABIALIS. 

An acute inflammatory affection of the skin around the mouth and 
nose. 

Causes. — They may be due to fever, to digestive disturbance, or to 
local congestion. 

Symptoms. — Clusters of small areas of raised vesicles containing a 
clear or opaque fluid. These vary in size from a pin-point size to that of 
a pea. They are often preceded by heat and swelling in the locality. 
After a short time they crust over and disappear without leaving a scar. 

Treatment. — They seldom require serious treatment, though they are 
often painful and always unsightly. The application of a good toilet 
powder dusted upon them, or cold cream, or a solution of boric acid, a 
teaspoonful to a pint of water, will lessen the itching and prevent 
contagion. 



DISEASES OF THE MOUTH, 

CHAPPED OR CRACKED LIPS. 

The lips are often chapped and cracked by exposure to cold, and it 
is sometimes a difficult matter to heal them. The following is a good 
form for lip-salve to be used in such a case : — 

White Wax, 2^ ounces. 

Spermaceti, y 2 ounce. 

Almond Oil, 3 ounces. 

Melt together, stir well, and put by to cool. Apply to the lips on 
going to bed at night. It may be made of a pretty pink color first by 
tinting the oil with a small piece of alkanet root, which should be taken 
out before the other ingredients are introduced. When the lips heat 
and burn much, a little cold cream will be found a pleasant and service- 
able application. 



SORE MOUTH. 333 

SALIVATION OR MERCURIAL STOMATITIS. 

Causes. — Occurs in those poisoned by mercury when working with 
the same, or from overdosing. 

Symptoms. — The secretions of the mouth are increased; the breath 
is foul ; there is a bad taste in the mouth ; the gums swell ; are inflamed, 
soft; and the teeth are sensitive and may become loose. There is usu- 
ally loss of appetite and diarrhoea. 

Treatment. — 

Creolin, 30 drops in four ounces of water. 

Use as a mouth wash every three hours. 

Or:— 

A small piece of alum dissolved in a little water and applied on a 
swab to the gums to pucker them and prevent further softening. 

Or:— 

Tincture of Myrrh, 3 drams. 

Chlorate of Potash, 30 grains. 

Chloride of Soda, 2 drams. 

Distilled Water, to make 8 ounces. 

Mix and use as mouth wash every two hours. 

Internally, use iodide of potash, five to ten grains in half a glass 
of water three times daily to eliminate the poison. 

GUMBOIL. 

Causes. — This sometimes arises from exposure to cold, but is caused 
in the majority of cases by the irritation of a decayed tooth. 

Treatment. — Inflammation of the gum generally goes on to suppura- 
tion, to promote which warm fomentations and poultices may be applied 
externally. As soon as the matter is formed the abscess may be cut or 
lanced. Afterwards the mouth should be washed occasionally with an 
astringent lotion composed of tincture of myrrh and water, or of twenty 
or twenty-five grains of sulphate of zinc, dissolved in half a pint of rose 
water. 

STAMMERING. 

This defect of speech sometimes proceeds from functional disorder, 
sometimes from nervousness, sometimes it is the result of irritation. 



334 



DISEASES OF ADULTS. 



From whatever cause it originates, it is in the majority of cases to be 
cured by an exertion of the will. 

Treatment. — Stammerers, although they cannot speak a single 
sentence without hesitation, can sing a song of many verses as fluently 
as any person. It is to be recommended that those who stammer should 
begin with a set of exercises of commonplace sentences, chant to the first 
bars of the simplest melody, such as "My Country," and, from that, 
practise those sentences upon one note ending a note lower or higher, 
slowly at first, but gradually increased to rapidity. 

SORE TONGUE. 

The tongue is liable to become sore or ulcerated, most commonly along 
the edges ; and there are frequently seen small pimples and cracks. 

Treatment. — Take mild and cooling aperients, particularly calcined 
magnesia, either alone or in a Seidlitz powder. Let the drink consist 
chiefly of soda water, and the diet be light and cooling. Touch the 
sores with burnt alum and wash the mouth frequently with borax and 
honey dissolved in water. 

INFLAMMATION OF THE TONGUE OR GLOSSITIS. 

Causes. — Mechanical injury, very hot fluids, corrosive poisons, sharp 
edges of teeth, and irritation from tobacco pipe stems. 

Symptoms. — The tongue becomes greatly swollen and is painful. 
There is fever, rapid pulse, and increased flow of saliva. Respiration and 
deglutition (swallowing) are much interfered with, and the voice is 
muffled. 

Prognosis. — The chief dangers are suffocation and abscess formation. 

Treatment. — Ice held in the mouth and the use of purgatives 
together with small doses of tincture of aconite, two to four drops every 
hour, until fever subsides or sweating is produced. If these measures 
fail, the tongue must be scarified deeply to afford relief. Abscesses must 
be opened. In chronic cases apply with a camel's-hair brush silver 
nitrate, ten grains to an ounce of distilled water, to the ulcerations, and 
administer tonics. 

A good mouth wash, such as listerine or boric acid solution, should 
be constantly used. 



PHARYNGITIS. 335 

DISEASES OF THE THROAT. 

SORE THROAT OR ACUTE PHARYNGITIS. 

Inflammation of the throat or pharynx. 

Causes. — Exposure to cold ; insufficient clothing ; too much clothing ; 
a too rich diet with hot drinks; obstructions in the nose and pharynx; 
scrofulous or gouty tendency. 

Symptoms. — Pain in swallowing; persistent clearing the throat; 
impaired hearing ; loss of taste ; and mouth breathing. 

Prognosis. — Nearly always very favorable when treated. 

Treatment. — Sucking of ice; cold sprays; application to the throat 
by oil atomizer of : — 

Guaiacol, i ounce. 

Sweet Oil i ounce. 

Or:— 

Menthol, y 2 ounce. 

Olive Oil, 2 ounces. 

Apply by spray. 
Or:— 

Chlorate of Potash, 15 grains. 

Water, 1 ounce. 

Gargle frequently. 

If there is reason to believe that the stomach is disordered, J4 grain 
doses of calomel every two hours for four doses, followed in six hours 
by a full dose of Epsom salts, will be of much benefit. 

"CLERGYMAN'S SORE THROAT" OR CHRONIC 
PHARYNGITIS. 

An inflammation of the back part of the throat easily visible when 
the mouth is opened wide. The vocal cords and the larynx are usually 
affected. 

Causes. — Over-exertion and improper use of the voice; inhaling 
irritating vapors ; digestive disturbances ; and excessive smoking. 

Symptoms. — At first the mucous membrane is red and inflamed, 
and is studded with glandular follicles and lymphatic little glands. The 



336 DISEASES OF ADULTS. 

voice is husky and the throat is dry. There is increased difficulty in 
using the voice with constant clearing of the throat. There is also 
difficulty in swallowing. 

Treatment. — This should be first directed against the underlying 
causes. The voice must be saved, and whatever practices cause or 
aggravate the complaint must be stopped. Tonic medicine, fresh air, 
and good diet must be observed. For local treatment use antiseptic 
washes in the pharynx and nose, such as Dobell's solution : — 

Bicarbonate of Soda, i dram. 

Carbolic Acid, 30 grains. 

Glycerine, 1 ounce. 

Boiled Water, 2 pints. 

Or:- 

Zinc Sulphate, 5 grains. 

Water, 1 ounce. 

Use as a gargle. 

Or:— 

Silver Nitrate, 15 grains. 

Water, 1 ounce. 

Use as a gargle. 

A very beneficial and agreeable spray is : — 

Menthol, 2 grains. 

Eucalyptol, 1 grain. 

Liquid Vaseline, 1 ounce. 

Use with an oil atomizer. 



INFLAMMATION OF THE TONSILS OR TONSILITIS. 

Redness and swelling of the tonsils due to inflammation of the soft 
tissues. 

Causes. — Exposure to wet and cold ; sudden changes of temperature ; 
imperfect protection of the feet in damp weather ; rheumatic or scrofulous 
tendencies; and previous attacks. It usually occurs in childhood and 
early adult life. 

Symptoms. — In the simple form there is swelling, redness, difficulty 
in swallowing. There is usually a warning chill followed by fever from 
102 to 104 ° ; headache ; and pain at the angle of the jaw. The breathing 
is difficult ; hearing impaired ; and the voice sounds distant and indistinct. 



TONSILITIS. 337 

Earache sometimes appears early. The tonsils are covered with light 
yellow colored spots which may be hastily taken to be the membrane of 
diphtheria. Usually the breath is fetid. 

Prognosis. — The disease usually terminates favorably; although 
suffocation may occur in cases of delicate children. 

Treatment. — The disease may frequently be aborted during the first 
24 hours of the attack by 4-minim hourly doses of tincture of aconite. 
This must be discontinued as soon as there is tingling in the ends of 
the fingers or a tickling in the throat. 

If a rheumatic tendency is ascertained, 3-grain hourly doses of the 
salicylate of soda may be given. This may be continued until there 
is a decided improvement. 

The patient is put to bed at once and a liquid diet is provided. 
Administer at once a powder of : — 

Calomel, 3 grains. 

Bicarbonate of Soda, 5 grains. 

Follow it in six or eight hours with a dose of Epsom or Rochelle salts or 
of Hunyadi water. 

The tonsils may be touched carefully with a solution : — 

Nitrate of Silver, 40 grains. 

Water, 1 ounce. 

Use a camel' s-hair brush or swab of absorbent cotton, taking care not 
to touch the surrounding parts. This may be done three times a day. 
Or:— 

Tincture of Chloride of Iron, 1 dram. 

Chlorate of Potash, y 2 dram. 

Water, to make 2 ounces. 

Mix. Use as a gargle every two hours, plain or diluted. 

In children who cannot gargle : — 

Tincture of Chloride of Iron, 3 drams. 

Glycerine, 3 ounces. 

Mix. Give one teaspoonful every two hours plain. 

Should the tonsilitis become chronic, excision of the tonsils may be 
necessary. 

When there are white patches on the tonsil, as in ulcerated sore throat, 
a gargle of peroxide of hydrogen, plain or diluted, is very efficient. 

When the attack has subsided the tonsils may be contracted by touch- 
ing them with : — 



2>& DISEASES OF ADULTS. 

Copper Sulphate, 20 grains. 

Water, 1 ounce. 

Or:— 

Monsel's Solution or Solution of Iron Sub- 
sulphate, 1 dram. 

Water, 1 ounce. 



QUINSY OR PERITONSILAR ABSCESS. 

An abscess of the tissues surrounding the tonsils. 

Cause. — This disease sometimes accompanies or terminates tonsilitis. 
It is inflammatory and is thought to be of the same origin. 

Symptoms. — The loose connecting tissues surrounding the tonsils 
are inflamed, and the movements of the jaw are painful; nasal breathing 
is impaired; the soft palate and the uvula are swollen and inflamed. 
The countenance of the patient appears anxious; the mouth hangs open 
and saliva escapes from it. 

Prognosis. — The termination of the disease is favorable. 

Treatment. — The disease may often be aborted in the first twenty- 
four hours by use of 4-minim hourly doses of tincture of aconite. If 
it is not aborted, hot poultices are applied to the neck in order to pro- 
mote suppuration and hasten the termination of the disease. As soon 
as the abscess has formed, incision is made at the side of the root of 
the uvula and the pus allowed to escape. Sometimes the abscess breaks 
of its own accord. The parts soon heal ; but it is not well to wait for 
the spontaneous bursting of the abscess, as the deep muscles of the 
neck may become involved and more serious consequences develop. 
Warm bran or flaxseed poultices are used to promote suppuration. 
Acid drinks, or pieces of ice retained in the mouth, are often grateful 
to the hot and dry throat. Relief from pain may be procured by 
inhaling the steam of hot water through a teapot or an inverted funnel. 

After the pus has discharged, a generous diet and tonic treatment is 
desirable. 



HOARSENESS OR LARYNGITIS. 

Inflammation of the larynx. 

Causes. — Improper use of the voice; insufficient clothing; poor 



ENLARGEMENT OF THE UVULA. 339 

ventilation; breathing irritating particles and gases; digestive disturb- 
ance ; abuse of alcohol ; excessive smoking. 

Symptoms. — Dry cough ; hoarseness ; swelling and sometimes 
hemorrhage; mucous membrane is evenly red and swollen. 

Prognosis. — If taken early and well treated, and the causes 
removed, the cure will in time be assured. If not, the disease will 
run three or four weeks and will leave the patient very susceptible 
to future attacks. 

Treatment. — Refrain absolutely from using the voice even in a 
whisper. The patient should remain in one room of an even tempera- 
ture of about 65 ° or 70 , the atmosphere of which is laden with 
moisture from boiling water. A bandage of cotton cloth wrung out of 
cold water every five hours is to be worn around the neck and held 
in place by a band of flannel. The compress is to be further moistened 
with the following solution : — 

Glycerine, 1 ounce. 

Tincture of Iodine, 1 dram. 

Water, to make 8 ounces. 

Moisten the compress twice daily. 

The throat may be thoroughly rubbed with camphorated oil. 
. % grain doses of calomel may be given every two hours until four 
doses have been taken; then follow in six hours with a full dose of 
Epsom salts. 

ENLARGEMENT OR SWELLING OF THE UVULA. 

The lengthening and enlarging of the uvula, which hangs downward 
at the back of the mouth from the palate over the base of the tongue. 

Causes. — A weakening or sometimes an absence of muscular fibers 
in the uvula. This may result from a partial paralysis of the muscles 
by diphtheria, scarlet fever, influenza, and similar diseases. It occurs 
at all ages and among speakers and singers especially. 

Symptoms. — Fits of coughing at evening and in the morning; 
tickling in the throat with pain and discomfort; deterioration of the 
singing voice; hoarseness; and sometimes blood-spitting. 

Treatment. — Astringent applications to shorten the uvula and to 
restore it to its place. Burnt alum blown against the uvula; a simple 
gargle of alum water; and washing with tannic acid or nitrate of silver 
with a camel's-hair brush will often suffice. If this is not efficacious 



340 DISEASES OF ADULTS. 

the uvula must be amputated. This is a simple operation in the hands 
of a competent surgeon. 

DROPSICAL INFLAMMATION OF THE LARYNX OR 
OEDEMATOUS LARYNGITIS. 

Inflammation of the mucous membrane of the larynx, glottis, and 
epiglottis, with an outpouring of blood serum into the tissues producing 
a dropsical condition. 

Causes. — Colds; eruptive fevers; breathing irritating vapors and 
particles; foreign bodies; tubercular and syphilitic affections. 

Symptoms. — Chill; fever; difficulty in breathing; extreme anxiety 
of expression; breathing inward is most difficult at first; wheezing; 
difficulty in swallowing; pain seems to be located at the "Adam's 
apple"; capillaries (minute blood vessels) in the throat very red; 
parts swollen. 

Prognosis. — If not relieved the patient dies of strangulation in 
from a few hours to five days. 

Treatment. — Prompt and vigorous treatment is demanded to 
overcome the tendency to suffocation. This is done by a physician, who 
scarifies the surface five or six times a day to allow the serum and 
fluids to run out and thus reduce the swelling. Steam inhalations and 
pieces of ice dissolving in the throat afford some relief. Ice bag on 
the neck over the seat of disease is beneficial. If pus is present it 
must be removed. Tracheotomy (cutting an opening into the throat 
from outside and the insertion of a silver breathing tube) is often 
necessary to save life. 



DISEASES OF THE LUNGS. 

COLD IN THE CHEST OR ACUTE CATARRHAL 
BRONCHITIS. 

Inflammation of the lining membrane of the bronchial tubes. 

Causes. — Sudden changes in temperature; cold winds; inhaling 
irritant vapors and dust; infection by micro-organisms; acute infectious 
diseases, such as typhoid fever, measles, etc. ; heart or kidney disease ; 
dentition in young children. 



ACUTE BRONCHITIS. 341 

Symptoms. — Chill; a short, dry, annoying cough; soreness under 
the sternum (breastbone) ; sense of weight or oppression on the chest; 
slightly quickened breathing; slight rise in temperature; and a rather 
higher than normal pulse. These are accompanied during the first 
day or two by fatigue ; furred tongue ; constipation ; and, in very young 
children, convulsions may be among the earliest symptoms. In a few 
days the pain in the chest increases and becomes tearing or burning in 
sensation and is aggravated by a deep breath or by coughing. The 
cough becomes loose and is followed by free expectoration. The 
sputum may be slightly stained with blood and soon becomes more 
abundant, of a greenish-yellow color. 

Prognosis. — There are a few deaths from acute bronchitis among 
the very young and the very old or those who are greatly enfeebled 
from other causes ; but the disease usually terminates favorably in about 
two weeks. Other cases may drag along and become chronic. 

Treatment. — The treatment during the first stage of the disease 
consists in an attempt to allay the inflammation. Hot foot-baths, hot 
drinks, and the following may be taken : — 

Dover's Powder, 2 grains. 

Make five such powders and take one every three or four hours. 

After which: — 

Wine of Ipecac, 1 dram. 

Solution of Potassium Citrate, 3 ounces. 

Solution of Ammonium Acetate, 3 ounces. 

Take a tablespoonful every two or three hours. 

If the cough and pain are severe a mustard plaster may be applied 
front and back and the chest and back afterwards well rubbed with 
either ammonia liniment or chloroform liniment. If the passages are 
very dry and the atmosphere of the room is also dry, much benefit 
results from allowing the steam from a kettle of boiling water to 
moisten the air. The boiling water may be beneficially medicated by 
putting into the water in the kettle from one to two grains of menthol 
every three or four hours. 

Or:— 

Compound Tincture of Benzoin, 1 ounce. 

Oil of Eucalyptus, 1 ounce. 

Oil of Pine, 1 ounce. 

Put a tablespoonful of this mixture into the kettle of boiling water 
every three or four hours. 



342 DISEASES OF ADULTS. 

If the case is persistent and does not yield to this treatment such 
cases require the following: — 

Terebene, 2 drams. 

Creosote, 24 drops. 

Mucilage of Acacia enough to mix. 

Chloroform Water, to make 3 ounces. 

Take one teaspoonful in water every four hours. 



CHRONIC BRONCHITIS. 

Winter coughs, catarrh, and asthma are very common forms of this 
disease. For the cough give : — 

Paregoric, ]/ 2 ounce. 

Syrup of Ipecac, 1 ounce. 

Syrup of Tolu, 2 ounces. 

Anise Water, 1 ounce. 

Mix and give one teaspoonful every two or four hours. 

If there is fever give : — 

Sweet Spirits of Niter, 15 drops. 

One such dose every two or four hours. 

It is during the spring months with an east wind that bronchitis 
attacks young and old with greatest frequency. With old persons, 
in such cases, there is commonly a great accumulation of mucus in the 
bronchial tubes, which causes continued and violent coughing in the 
efforts to expel it. Breathing is difficult ; the blood, from lack of proper 
oxygenation, becomes unfit for vital purposes and death is often a 
sudden termination of such cases. This form must be carefully treated ; 
no debilitating measures will do ; a warm, generous diet must be main- 
tained; warm flannel worn next to the skin; and inhalation of steam — 
if medicated with turpentine or balsam of Peru so much the better. 

The following mixture is of much benefit in these cases : — 

Creosote, 24 drops. 

Glycerine, 1 ounce. 

Wine of Burgundy, to make 3 ounces. 

A teaspoonful every two hours. 



PLEURISY. 343 

PLEURISY OR PLEURITIS. 

Inflammation of the membranes which line the thorax (chest) and 
which cover and protect the lungs, called the pleura. There are three 
varieties with reference to the duration of the disease : acute, sub- 
acute, and chronic ; and two varieties with reference to the presence 
or absence of liquid : dry pleurisy and pleurisy with effusion. When 
there is pus effused the disease is called empyema. 

Causes. — The presence of a micro-organism; cold; exposure; mus- 
cular exertion; injuries to the chest walls; a secondary result of 
pneumonia, tuberculosis, Bright's disease, inflammation of the heart 
membrane (pericarditis), rheumatism, scarlatina, smallpox, and measles. 
Tuberculosis, cancer, Bright' s disease, and alcoholism may cause 
chronic pleurisy. 

Symptoms. — Chill; pain or ''stitch" in the side; some fever; pain 
over the nipple is increased by breathing; patient "catches his breath" 
to ease the pain; breathing is short, rapid, shallow, from 30 to 35 
respirations a minute; a short, dry, hacking cough, and a pulse from 
90 to 120 per minute. When effusion of liquid occurs the pain is 
usually less severe. The patient lies on the paining side and rather 
crouches to get relief. The breathing may be one-sided for the same 
reason; this form of breathing may sometimes be seen. After the 
absorption of the liquid the condition is much improved and the con- 
valescence is rapid. 

In the chronic form there is a longer duration ; night sweats ; 
palpitation; greater difficulty in breathing; disturbed circulation; and 
some prostration. 

Prognosis. — Usually the disease terminates in recovery in about 
three weeks. Complications often make the disease a very serious one. 
Empyema (pleurisy with suffusion of pus) is almost uniformly favor- 
able in prognosis. There is in pleurisy with effusion some danger of 
death if the amount of suffused liquid is very large. 

Treatment. — Rest and a semi-solid or liquid diet are to be first 
secured. The pain, if great, may be controlled by 3-grain doses of 
Dover's powder every two or three hours ; and also by binding the 
thorax with strips of adhesive plaster on the painful side from the 
middle of the back to the breastbone. This prevents the motion of the 
chest in breathing and coughing. If the disease is recognized very 
early the seriousness may be modified bv ; — 



344 DISEASES OF ADULTS. 

Salicylate of Soda, 15 grains. 

Take one such powder in a wineglass of water every three or four 
hours. 

After effusion of liquids has taken place the following should be 
given : — 

Acetate of Potassium, 30 grains. 

Infusion of Digitalis, 2 drams. 

Take one such dose every three or four hours. 

The use of poultices and of hot applications is of rather doubtful 
value on account of the very great risk which the patient runs of taking 
cold. Attempts to promote infusion by strong purgatives, sweating 
and similar means are also seldom of benefit; besides they have a 
weakening effect upon the patient. If the liquids do not disappear by 
absorption they are withdrawn by use of a needle-like tube (an 
aspirator). This and the withdrawal of pus in empyema are matters 
for the attention of the surgeon. 



DROPSY OF THE PLEURA OR HYDROTHORAX. 

The presence of a liquid in the pleura. 

Causes. — Heart disease; kidney disease; inflammation of the liver; 
and consumption. 

Symptoms. — The symptoms of pleurisy generally. The fact that 
it is generally found on both sides of the chest; that there is a history 
of other diseases mentioned in the causes of the disease, and that there 
is no fever or pain distinguishes it from pleurisy. 

Prognosis. — The termination depends upon the other diseases of 
which this is an accompaniment. 

Treatment. — The fluid may be absorbed by the use of saline 
purgatives and hydrogogue cathartics such as : — 

Epsom Salts, y 2 ounce. 

Take one such dose every morning before breakfast. 

At the same time take : — 

Solution of Iron and Ammonia Acetate, ... 2 ounces. 

Take one tablespoon ful every four hours. 

The application of dry cups over the chest frequently affords relief. 
It may be necessary to withdraw the fluid by surgical means. 



ASTHMA. 345 

When air is present in the cavity of the chest, the disease is known 
as pneumothorax. Its treatment is along the same lines as in pleurisy. 

Air and water together in the cavity produces hydropneumothorax ; 
and pus and air together, pyopneumothorax. 



ASTHMA. 

This is a disease of the lungs, whose main characteristic is laborious 
breathing, which comes in paroxysms, and is accompanied by a 
wheezing noise. Humid asthma is that in which the attack terminates 
in expectoration; when it does not, this is called dry asthma. Persons 
so afflicted have generally disease of the heart or lungs; but, if not, it 
is called spasmodic asthma. 

Causes. — Hereditary predisposition ; dwelling in a cold or moist 
atmosphere, or being subject to sudden changes of temperature; gout; 
intense study; great mental anxiety; suppression of perspiration; 
irritation of the air-cells and lungs by atmospheric impurities; irritation 
of the stomach, uterus, or other viscera. 

Symptoms. — The attack commonly occurs in the night, the patient 
having gone to bed in a listless, drowsy state, with a troublesome cough, 
oppression at the chest, and symptoms of flatulence. Towards mid- 
night the breathing becomes more labored, the wheezing sounds 
louder, and the patient is obliged to assume an erect posture to prevent 
suffocation. Sometimes he starts out of bed, and rushes to the window 
for air, or he sits with his body bent forward, his arms resting on his 
knees, with a flushed or livid face, or deadly pale, gasping and 
struggling for breath, in a condition painful to behold. The pulse is 
weak and intermittent, with palpitation of the heart; sometimes there is 
vomiting, with involuntary emission of the urine, which is of a pale 
color, and relaxed bowels. The attack will probably last for two 
hours or more, when the severe symptoms will gradually remit, with an 
expectoration of frothy mucus, and a tranquil sleep follows. For some 
days there will be felt a tightness of the chest, and the slightest exertion 
brings on a difficulty of breathing; there will be slighter paroxysms, and 
after a longer or shorter period another severe one. 

Prognosis. — Asthma is never fatal by itself; but there are 
complications which often terminate so. The disease is essentially 
chronic and can never be said to be cured. 



346 DISEASES OF ADULTS. 

Treatment. — The objects to be attained in this are, first, to 
moderate the violence of the paroxysm ; second, to prevent its recurrence. 
Gentle aperients should be administered, and anti-spasmodic mixtures ; a 
mustard plaster on the chest will often afford much relief. Castor oil, 
given in peppermint, or weak brandy and water, is a suitable aperient. 
Where there is reason to suppose the stomach is overloaded, an emetic 
should be given. Tincture of lobelia inflata is good in obstinate cases, 
dose one dram. Inhaling the fumes of stramonium is sometimes of 
service, and the good effect will be assisted by a cup of hot coffee, 
putting the feet in warm water, or using the warm bath. 

For bronchial asthma, Gardner's syrup of hydriodic acid, a half- 
teaspoonful every four hours, is very efficient, together with the 
following : — 

Stramonium Powder, i ounce. 

Belladonna Powder, i ounce. 

Hyoscyamus Powder, i ounce. 

Nitrate of Potash Powder, i ounce. 

Mix and burn on a shovel and let the patient inhale the fumes. 
In asthma due to heart trouble use : — 

Fluid Extract of Apocynum Cannabin, 2 drams. 

Fluid Extract Cactus Grandiflora, 2 drams. 

Gardner's Syrup of Hydriodic Acid, 

enough to make 3 ounces. 

Mix. One teaspoonful every four or five hours. 

To prevent the return of a paroxysm of asthma, avoid the exciting 
causes, keep the bowels open with some mild aperient, and strengthen 
the system by bitter infusions, such as camomile or gentian. If there 
is tightness of the chest, put on a poultice, and take an expectorant now 
and then to clear out the phlegm from the bronchial passages. Take 
a light nourishing diet, avoiding everything difficult of digestion; wear 
warm clothing, as flannel next to the skin; take regular and moderate 
exercise; change of climate if possible, should the situation occupied be 
damp, or bleak and exposed. Do not indulge in sensual or intemperate 
habits. 

Eclectic Treatment for Asthma. 

When the symptoms appear, at once place the feet in warm water, 
and take a decoction of catnip or pennyroyal, to produce a gentle 



HAY ASTHMA. 347 

perspiration. If the attack still continues, take a tablespoonful of the 
tincture of lobelia in a cup of warm tea, every half hour. The following 
remedy has produced marked results in severe cases : Take a half 
ounce of well-bruised seneca snakeroot; immerse in one pint of water, 
and boil over a slow fire till reduced to a half pint. Dose, a table- 
spoonful every ten or fifteen minutes. A teaspoonful of mustard-seed, 
taken in tea or soup, morning and evening, has cured many severe cases. 
Damp houses and damp air must be carefully avoided. Let the food 
be light and nutritious; sleep on a hard mattress; and frequently take 
the country air. 



HAY ASTHMA OR HAY FEVER, THE ROSE. 

This is a catarrhal inflammation of the respiratory tract occurring 
most frequently in the spring and fall. 

Causes. — It is caused by the inhalation of certain vapors, the pollen 
of plants, and odors emanating from some animals. 

Symptoms. — Those of a severe cold in the head; sneezing; watery 
discharge from the nose; more or less deafness; irritation of throat 
and nose; wheezing cough; and difficult breathing. The condition 
may last for a period of weeks each year, disappearing for a few days, 
then beginning again. 

Treatment. — When disease of the nasal turbinated bones exists, 
their removal usually causes a cure. In other cases there is no treat- 
ment that is positively curative. A change of residence to a higher, 
dryer climate, or a sea voyage will sometimes overcome the condition. 
The medical treatment is varied. Quinine sulphate, five grains three 
times daily, taken for a month or so before an expected attack, has 
been recommended. During the attack the same treatment three 
times daily and an ointment containing thirty grains of quinine to 
the ounce applied to the nostrils is often beneficial, as is also the 
following : — 

Extract of Hyoscyamus, 12 grains. 

Iodide of Potash, 60 grains. 

Bicarbonate of Potash, 2 drams. 

Extract of Licorice, 4 drams. 

Anise Water, to make 5 ounces. 

Mix. Two teaspoonfuls every four hours until relieved. 



348 DISEASES OF ADULTS. 



BLEEDING FROM THE LUNGS OR HEMOPTYSIS. 

This denotes in general the spitting of blood, and is commonly 
used by pathologists to signify the expectoration of blood from the 
lungs and air tubes. It is important to ascertain the source of the 
blood which escapes from the mouth, and, if determined to be from 
the lungs, to ascertain whether it is symptomatic of disease of these 
organs, or merely vicarious in its character. It is not so much 
dangerous in itself as it is rather an indication of some other dangerous 
disease, being most frequently connected with tubercular consumption. 

Causes. — Bleeding from the lungs may occur without organic 
disease, in the plethoric and robust who live a life of excitement 
and excess, and in nervous, irritable individuals, weakened by mental 
or bodily fatigue, and leading sedentary lives. It is often hereditary, 
and may be brought on by violent muscular effort, paroxysms of cough, 
blows or pressure on the chest, inspiration of irritating vapors, or of 
rarefied air on high mountains. The blood may be exuded from the 
tracheal or bronchial membranes, or it may proceed from capillaries 
communicating with the air passages in any part of their extent. The 
amount varies from a dram to a pint at a time, and is generally florid, 
and more or less mixed with air, differing from the dark, coagulated 
blood which comes from the stomach. 

Prognosis. — This is rarely a fatal disease, but death may occur 
from complications. If the causes is consumption or aneurism death 
may follow. 

Symptoms. — An attack is frequently announced by a feeling of 
heat and oppression in the chest behind the sternum, followed by a 
cough which brings up the blood. When the quantity is very great 
it pours forth without a cough, and almost by an act of vomiting, with 
considerable spasmodic effort. 

Treatment. — Elevating the breast and shoulders, admitting plenty 
of fresh air, with spare diet and perfect quiet, are among the most 
useful measures to be adopted. The chest should be sponged with 
vinegar and cold water, and a dessertspoonful of the former in half a 
wineglassful of the latter will be a useful accompaniment to any other 
medicines which may be thought necessary. The oil of turpentine, 
ten to thirty drops in a glass of water; or gallic acid, in doses of ten 
to fifteen grains, every three or four hours, have been found of great 



PNEUMONIA. 349 

value. Cold liquids, and the sucking of pieces of ice, will be of service. 
Nauseating medicines, as tartar emetic and ipecacuanha, are also 
frequently employed. A teaspoonful of common salt, taken frequently, 
is an excellent popular remedy. In all cases, calmness of mind, rest, 
silence, erect position, cool air, and freeness of the bowels should be 
enjoined. When the attack proceeds from congestion, blood-letting 
is recommended in certain cases. If cough be present, it should be 
allayed by narcotics. After the attack, astringent tonics, as iron and 
quinine, may be given; and the return of the bleeding is to be guarded 
against by avoiding the exciting causes, and attending to the general 
health. 

LOBAR PNEUMONIA OR LUNG FEVER— WINTER FEVER. 

Pneumonia is an acute infectious inflammation of the lung struc- 
ture, involving not only the vascular tissues but also the air cells, which 
are rendered impervious to air by the disease. 

Causes. — The germ of pneumonia (diplococcus pneumoniae of 
Fraenkel). Whatever debilitates the system may act as a predisposing 
cause. Persons suffering from malarial poison, the grip, and acute 
diseases are liable to attacks of pneumonia. Age, intemperance, climatic 
changes, impure air, and other similar factors may be regarded as 
agents in its production. 

Symptoms. — The onset of pneumonia is sudden and the first 
notable symptom is usually a chill perhaps accompanied by headache 
and pain in the back or limbs. In a short time the chill is followed 
by fever, pain in the chest, shallow, rapid, and painful breathing and a 
short, hacking, and suppressed cough. If the ear is placed over the 
chest a crackling sound is heard which can be imitated by rolling a 
hair between the thumb and ringers. The portion of lung involved 
is congested with blood in the first stage, which causes a serious 
obstruction to the circulation; the heart is thus embarrassed in doing 
its work. The products of inflammation are pressed out into the air 
cells. In about two days after the onset of the disease, the disabled 
portion of the lung solidifies and percussion gives a dull sound. The 
temperature is much elevated, the urine is scanty and high colored. 
The patient wears an expression of anxiety and distress. The cough 
is more painful and brings up a rust colored sputum known as the 
prune juice expectoration. The breathing is labored and painful. The 



350 DISEASES OF ADULTS. 

respiration, which in health averages about seventeen a minute, runs 
up to forty, or in extreme cases to sixty, which indicates that the 
functions of the lung are greatly disturbed. In about five or six days, 
if the case goes on favorably, the morbid material in the air cells 
begins to soften and is absorbed into the circulation and removed from 
the system. The temperature declines, the fever abates, moisture 
appears upon the surface of the body, the patient feels relieved and 
shows marked signs of improvement. This is known as the stage of 
resolution and occupies from two to six days. The disease does not 
always follow the ordinary course. The process of inflammation may 
advance from one portion of the lung to another, and having traversed 
one lung may invade the other. Where both lungs are involved the 
case is one of double pneumonia, where a single lobe of one lung is 
invaded it is called lobar pneumonia. 

If the pulse is weak and rapid, above one hundred and twenty a 
minute, and the temperature continues above one hundred and four 
degrees, the disease is severe and liable to terminate unfavorably. 
When the case is severe, with a brown, dry tongue, it is sometimes 
called typhoid pneumonia. 

If the patient complains of a sharp stitch in the side, the compli- 
cation with pleurisy must be considered. 

Abscess of the lung sometimes follows pneumonia and recovery 
is tedious. 

Treatment. — The treatment must be prompt and meet the symptoms 
as they develop. Careful attention to the symptoms, and prompt 
medical aid in the early stages, will generally gain the mastery of the 
disease. 

In the onset a full dose of quinine will often reduce the temperature, 
produce perspiration, antagonize the poison depressing the nerve centers, 
and afford marked relief or even abort the disease. 

A mustard poultice over the chest acts as a powerful stimulant to 
the cutaneous nerves, and may help to abort the diesase if used early. 

In robust persons where there is no weakness and depression, one 
one-hundredth of a grain of tartarized antimony may be given every 
two hours advantageously, but should only be given in the first stages. 

In the second stage carbonate of ammonia is a remedy of great use. 
It stimulates the lungs, and aids the respiration and circulation. Five 
or ten grains in fluid extract of licorice every two or four hours is a 
proper dose. 



CONSUMPTION. 351 

Acetanilid is a valuable remedy in experienced hands to lower the 
temperature. Its use is not devoid of danger, however. 

A tendency to heart failure must be met by giving digitalis and 
suitable stimulants. These can be used safely and satisfactorily only 
by skilled persons. 

Pneumonia in children above two years of age does not often prove 
fatal if properly and promptly treated. 

Camphor liniment, flaxseed poultices, and the cotton jacket padded 
to oil silk are well known and serviceable remedies. Tincture of 
aconite in the early febrile stage is serviceable, especially in cases of 
children; ten drops in one-half tumbler of water, and of this mixture 
give one teaspoonful every half hour till it moistens the surface of 
the skin. 

Demulcent drinks of slippery elm and flaxseed are soothing and 
serviceable. 

Lemonade, in which is dissolved one teaspoonful of cream of tartar 
to a half pint, makes a cooling and refreshing drink; it also favors 
the secretion of urine and slightly relaxes the bowels. The patient 
should have pure air, the sick room being reasonably ventilated. 

No one but an experienced physician should attempt to treat a case 
of this kind. 

CONSUMPTION. 

Phthisis, or consumption, is a disease which, unfortunately, is but 
too prevalent and fatal in this country, as in most others. It spares 
neither age nor sex, and its attacks, at first so insidious as almost to 
escape notice, too frequently lead to a fatal issue. It is the result of 
the formation and development of tubercles in the lungs. These first 
appear in the form of small, gray, semi-transparent granulations, which 
gradually enlarge and become opaque, and after a time empty them- 
selves into the bronchial tubes, and thus the substance of the lung is 
gradually destroyed. 

Causes. — The tubercle bacillus; heredity; debility and chronic 
diseases, like Bright's disease and syphilis ; acute affections sometimes 
terminate in phthisis. Other exciting factors are unhealthy sanitation 
and certain occupations — mining, milling, etc. 

Symptoms. — The disease begins insidiously with loss of appetite, 
dyspepsia, and more or less gastric pain after meals. The subject 



352 DISEASES OF ADULTS. 

becomes pale and bloodless and complains of general weakness. Later, 
there develops a short, dry cough, exciting no particular attention, 
being attributed to a slight cold. It, however, continues, and after a 
time increases in frequency. The breathing is more easily hurried by 
bodily motion, and the pulse becomes more frequent, particularly after 
meals and towards evening. Towards evening there is also frequently 
experienced a slight degree of chilliness, followed by heat and nocturnal 
perspirations. This is commonly called night sweats. The patient 
becomes languid and indolent, and gradually loses strength. After a 
time the cough becomes more frequent, and is particularly troublesome 
during the night, accompanied by an expectoration of a clear, frothy 
substance, which .afterwards becomes more copious, viscid, and opaque, 
and is most abundant in the morning; the sputum is often tinged with 
blood; or hemoptysis occurs in a more marked form, and to a greater 
extent. As the disease advances, the breathing and pulse become 
more hurried; the fever is greater, and the perspirations more regular 
and profuse. The emaciation and weakness go on increasing; pain is 
felt in some part of the thorax, which is increased by coughing, and 
sometimes becomes so acute as to prevent the patient from lying on 
the affected side. All the symptoms increase toward evening: the face 
is flushed; the palms of the hands and soles of the feet are affected 
with a burning heat; the feet and ankles begin to swell, and, in the last 
stage of consumption, there is nearly always profuse diarrhoea. The 
emaciation is extreme; the countenance assumes a cadaverous appear- 
ance, the cheekbones are prominent, the eyes hollow and languid. "The 
emanation, pallor, and weakness become extreme." Failing circulation, 
toward the end, is indicated by more or less puffiness about the ankles. 
"The mind remains clear and hopeful to the last." 

Sea voyages, and residence at the seaside, are generally found to 
be very beneficial ; and, as a general rule, those places that are least 
subject to variations of temperature are recommended. The practice, 
however, of sending patients in the last stage of consumption away 
from home — to California, Florida, or elsewhere — cannot be too 
strongly reprobated. No one should be allowed to sleep with a con- 
sumptive patient after the disease has fully manifested itself. The 
contagious principle is found not in the breath, but in the sputum 
which is raised from the lungs ; this should be destroyed. 

The acute variety runs a rapid course, terminating fatally in a few 
months. Sub-acute and chronic types, under careful treatment and 



CONSUMPTION. - 353 

the proper hygienic surroundings, may be arrested, and the patient 
restored to a state of health; and, even where this is not the case, the 
progress of the disease will at least be retarded. Tonic medicines, 
such as bark, sarsaparilla, iron, and iodine, are also very beneficial in 
the treatment of phthisis; at least in those cases where inflammation 
or much febrile excitement does not exist. The treatment comprises 
a proper attention to the digestive organs, with wholesome diet, exercise 
in the open air, regular habits, attention to the skin, and, if necessary, 
change of air. The diet should be nutritious, but not stimulating, and 
the exercise not violent nor too prolonged. 

When the stomach symptoms are so severe that they interfere 
with the patient's nutrition, the following is often beneficial : — 

Fowler's Solution of Arsenic, i dram. 

Tincture of Nux Vomica, 2 drams. 

Chloroform Water, to make 4 ounces. 

Mix. Give one teaspoonful in a wineglass of water before meals. 

Sometimes it may be necessary to use a sedative mixture such as : — 

Bismuth Subnitrate, 160 grains. 

Dilute Hydrocyanic Acid, 32 drops. 

Cinnamon Water, enough to make 2 ounces. 

Mix. Give one teaspoonful every two hours until vomiting or 
nausea ceases. 

Constipation is relieved by attention to the diet and administration 
of fruit or fruit juices, by soap and water or olive oil injections, 
avoiding so far as possible the use of cathartics. 

Diarrhoea commonly subsides by a strict regulation of the diet, 
and the avoidance of all stimulating food and medicine; otherwise, 
small doses of chalk and opium, or rhubarb and opium, may be 
administered. When the pulse is very frequent and the palpitation 
distressing, digitalis may be used. 

But little can be done for the reducing of fever. The patient while 
feverish should be in bed or on a couch and given a sponge bath with 
tepid water and alcohol, and in addition either of the following com- 
binations used to reduce the temperature : — 

Antipyrine, 1 dram. 

Syrup of Orange, 1 ounce. 

Water, • to make 3 ounces. 

Mix. Give two teaspoonfuls three times daily when required. 



354 DISEASES OF ADULTS. 

Or a capsule containing: — 

Sulphate of Quinine, 5 grains. 

Dover's Powder, iy 2 grains. 

May be given from three to five hours before the expected rise of 
temperature. 

For night sweats : — 

Peruvian Balsam, 15 minims. 

Formic Acid 1 dram. 

Chloral Hydrate, .75 grains. 

Alcohol, 4 ounces. 

Sponge the body with this at bedtime. 
And internally : — 

Camphoric Acid, 4 drams. 

Sugar of Milk, 2 drams. 

Mix. Divide into sixteen powders. Use one on retiring and 
another two hours later if needed. 

For the cough : — 

Dionin, J /g to %. grain. 

Dilute Hydrocyanic Acid, 2 drops. 

Syrup of Tolu, to make 1 dram. 

Mix. Administer this every three hours until relieved. 
When the cough is excessive and there is but little secretion the 
following will be found efficient : — 

Terebene, 80 drops. 

Spirits of Chloroform 160 drops. 

Dilute Hydrocyanic Acid, 20 drops. 

Syrup of Acacia, to make 2 ounces. 

Mix. Give one teaspoonful in a little water every three hours. 

For hemorrhages from the kings (Hemoptysis) : — 

Stypticin, 8 grains. 

Peppermint Water, 1 ounce. 

Mix. Give one teaspoonful every hour until relieved and apply 
an ice bag to the chest. 

As so much depends in the treatment of consumption upon the full 
assimilation of as large quantities of good nourishing food as possible, any 
digestive disturbances are to receive immediate attention. These are 
sometimes brought about by drugs given to relieve other conditions. In 
this event the use of such offending medicines is to be discontinued. The 
general principles of treatment for dyspepsia will then obtain. (See 
"Modern Methods of Treating and Curing Consumption," page 165.) 



HEART DISEASE. 355 

DISEASES OF THE HEART. 
DILATATION OF THE HEART. 

Increase in size due to the enlargement of one or more of the 
cavities of the heart. 

Causes. — Chronic disease of the valves of the heart; effusion of 
fluids; chronic bronchitis; Bright's disease; alcoholism; and syphilis. 
Over-exertion frequently causes it in delicate persons. 

Symptoms. — Poor circulation; feeble pulse; headache, increased by 
standing or sitting upright; fainting; cough; difficulty in breathing; 
dizziness; bleeding at the nose; dyspepsia; constipation; dropsy; and 
mental dullness. 

Prognosis. — This is unfavorable. Death results either suddenly 
from paralysis of the heart caused by over-excitement, or gradually 
from exhaustion. 

Treatment. — The disease is incurable and all that can be done is 
to afford relief. The first point to attend to is the nourishment of the 
patient by generous diet, moderate exercise, and the making of good 
blood by the use of red wines, iron preparations, etc. A very rigid 
hygiene must be observed. Heart tonics, such as digitalis, may be 
administered in some such form as: — 

Tincture of Nux Vomica, •• . . J4 ounce. 

Tincture of Digitalis, J4 ounce. 

Take fifteen drops in water after each meal. 

Or:— 

Tincture of Digitalis, 1 J^ drams. 

Tincture of Cereus Grandifloris, 1 ounce. 

Citrate of Caffeine, 1 dram. 

Compound Tincture of Cardamom, to make 4 ounces. 
Take a teaspoonful in water three or four times a day. 

During the intervals of attacks, rest, diet, and the removal of 
exciting causes are to be attended to. Great care must be taken that 
there is no constipation or the formation of gas in the stomach. Tonics 
such as arsenic, iron, strychnine, etc., are of value. They are used to 
fortify the system against later attacks. Cold baths must not be given 
under any circumstances during this condition. 



356 DISEASES OE ADULTS. 

INFLAMMATION OF THE PERICARDIUM OR 
PERICARDITIS. 

Inflammation of the membrane which envelops the heart. 

Causes. — That form which results directly from cold and exposure 
is seldom seen, for it is most frequently of secondary nature and 
origin. It either follows or is connected with rheumatism, scarlet 
fever, influenza, smallpox, tuberculosis, blood poisoning, Bright's 
disease, diabetes, and pneumonia of alcoholics. 

Symptoms. — Chills; remittent fever, sometimes nausea and vomit- 
ing; distress and tenderness over the heart; sharp, shooting pains; dry, 
suppressed cough which increases the pain; and often severe palpitation. 
After a few days there is effusion of liquid with oppression around the 
heart much increased; fainting; extreme difficulty in breathing, so that 
the patient cannot lie down; vomiting; and, sometimes, delirium. 

Prognosis. — Usually favorable; but when pus is present in effusion 
the termination is usually fatal. Relapses are to be guarded against. 

Treatment. — Rest; mental quiet; milk diet; dry cups applied to 
the region of the heart ; poultices ; blisters ; or cold applications, ice 
bags, etc., are often preferable. Hypodermic injections of morphine 
are often needed to allay the severe pain. The following is useful in 
lessening the inflammation and in relieving stomach and intestine 
disturbances : — ■ 

Calomel, i grain. 

Bicarbonate of Soda, 2 grains. 

Sugar of Milk, 2 grains. 

Make six such powders and take one dry on the tongue every two 
hours until the bowels move freely. 

The liquid diet should be maintained during the period of effusion, 
and the use of stimulants and tonics should be free. 

Inflammation of the heart (Carditis) itself sometimes occurs, but 
it is usually accompanied with inflammation of the pericardium. The 
symptoms in both cases are the same, and the treatment will, conse- 
quently, be similar. In inflammation of the interior lining membrane 
of the heart (Endocarditis) there is more or less of fever and anxiety, 
and a peculiar sound of the heart may be heard. A disease so 
dangerous as pericarditis should always have the prompt attention of 
a physician. 



PALPITATION. 357 



PALPITATION OF THE HEART. 

Functional disturbance i >t the heart marked by increased frequency 
of its action with lack of rhythm of its movements. 

Causes. — Over-exertion, anaemia, exhaustion, puberty, female sex, 

menstrual disorders, emotion, hysteria, heart-strain, abuse of tea. coffee, 
tobacco, and alcohol. 

Symptoms. — The attack is usually sudden, with some pain in the 
region of the heart. The beating of the heart is often so violent and 
rapid as to be visible through the clothing. The breathing is difficult 
and there is a choking sensation in the throat so that the patient is 
obliged to sit upright. There are vertigo: f aintness : face flushed or 
pale; anxiety and fear. The attacks last for a few minutes, a few 
hours, or for a day. After the attack the patient shows a great desire 
to sleep. 

Prognosis. — With early and effective treatment the termination is 
favorable. 

Treatment. — First, endeavor to remove the cause, whatever it may 
be. Then give : — 

Hoffman's Anodyne, I dram. 

Give one such dose every three hours. 

Or:— 

Aromatic Spirits of Ammonia, I dram. 

Give one such dose every three hours. 

If there is anaemia, the elixir of quinine, iron, and strychnine is 
beneficial. 

IRREGULAR PULSE OR ARHYTHMIA. 

A lack of rhythm or of regularity of heart beats, as shown in the 
pulse. It is a symptom rather than a separate disease. 

Causes. — It is caused by affections of the heart and arteries due 
to neurasthenia (nervous debility), hysteria, dyspepsia, and the abuse 
of tea, tobacco, and coffee. 

Symptoms. — The heart beats are irregular both in point of time 
and in force. The pulse may skip a beat now and then. There are 
always attendant symptoms of heart disease, either organic or 
functional. 



358 DISEASES OF ADULTS. 

Prognosis. — Entirely dependent upon the cause. If the disease is 
functional, the prognosis is favorable ; if organic, unfavorable. 

Treatment. — In* cases not due to organic heart trouble: — 
Bromide of Potash, 10 to 15 grains. 

Take one such dose three times a day. 

Or:— 

Bromide of Soda, 10 to 15 grains. 

Take one such dose three times a day. 

The diet must be well regulated; attention given to the bowels; 
and complete rest for both body and mind secured. 

In other cases bitter tonics and treatment directed to the causal 
heart trouble. In such cases a physician should be consulted. 

RAPID HEART OR TACHYCARDIA. 

Rapid heart action as indicated by the pulse. 

Causes. — Brain or spinal diseases ; change of life ; neurasthenia : 
irregularities of habit; excesses of any kind; chronic heart affections; 
excessive use of tobacco; high fever; etc. 

Symptoms. — The attack may come on suddenly with or without 
such warnings as dizziness or ringing in the ears. The pulse is increased 
to 150, 175, 200, or in very rare cases to 250 beats per minute. There 
is oppression over the heart and sometimes a sensation of smothering. 
The attack may last from a period of a few minutes to hours and 
days. 

Prognosis. — This is good, when the attack is caused by some 
removable affection. In cases of organic heart disease, it is sometimes 
terminated by sudden death. 

Treatment. — The patient must rest in bed; ice is to be applied over 
the heart. To quiet the nervous element of the attack use: — 
Bromide of Soda, 15 grains. 

Or:— 

Bromide of Potash, 15 grains. 

Take of either of these one such dose every four hours. 

Attention must be paid to the diet during the intervals between 
attacks. The food must be nourishing; and bitter tonics may be 
given. 



ANGINA PECTORIS. 359 

Fowler's Solution of Arsenic, 1 dram. 

Strychnia Sulphate, y 2 to 1 grain. 

Bitter Wine of Iron, enough to make 4 ounces. 

Take one teaspoonful in a wineglass of water after each meal. 



SLOW HEART OR BRACHYCARDIA. 

Either a sudden or permanent slowness of the heart action as 
indicated by the pulse. 

Causes. — It is present in some nervous diseases, fatty degeneration 
of the heart, and in the hardening of some of the muscles which supply 
the heart. Also in convalescence from diphtheria, pneumonia, typhoid 
fever, rheumatism, and erysipelas. It is found in epileptics, drunkards, 
anaemic persons, and in cases of lead poisoning. 

Symptoms. — The pulse beats from 40 down as low as 8 beats per 
minute. It is weak, low, and small. There are dizziness; disturbance 
of the hearing ; and fainting. Sometimes convulsions attend the attack. 
There may or may not be warning signs of its approach. 

Prognosis. — Like all heart cases, this depends upon the cause. 
When organic heart disease is the cause, death sometimes suddenly 
terminates the case. 

Treatment. — If the heart is beating fast enough to supply the needs 
of the body, no treatment is needed. If not, rest in bed; hot applica- 
tions of mustard over the region of the heart; and the employment 
of heart tonics. In cases of emergency these latter must be administered 
by hypodermic injection. Between attacks, nutritious diet and bitter 
tonics to improve the general condition of the patient must be used. 



NEURALGIA OF THE HEART OR ANGINA PECTORIS. 

Severe paroxysms of sharp pains in the region of the heart. 

Causes. — Lack of nutrition of the heart, either by diseased condi- 
tions or obstructions of the arteries which supply it; pressure of a 
tumor; very great dilatation or enlargement of the heart; great excess 
in the use of tobacco and narcotics; or disease of the valves. It is 
also present through heredity, syphilis, epilepsy; and the attacks are 
often precipitated by over-exertion, mental excitement, or acute 
indigestion. 



360 DISEASES OF ADULTS. 

Symptoms. — Excruciating pains around the heart, up to the neck, 
and down the left arm; difficulty in breathing; feeling of oppression 
over the heart ; weak heart action ; pale face ; fear of death ; perspiration 
in large drops over the body ; cold sweat ; extreme prostration. The 
attack lasts only a few seconds or minutes. It is usually followed by 
excessive flow of urine or by vomiting. It is very liable to recur for 
years. 

Prognosis. — Recovery from the first attack occurs in 75 per cent, 
of cases; but death usually ensues in later attacks. 

Treatment. — As the attack is of such short duration, prompt treat- 
ment is required to relieve the intense pain. If a physician is at hand 
he will do this by hypodermic injections of morphine, atropine, or 
nitro-glycerine. The inhalation of chloroform or of amyl nitrite is 
also beneficial. 

Or:— 

Chlorodyne, 10 to 15 minims. 

This dose repeated at intervals will afford relief. 
Hot mustard plaster or similar form of counter-irritation over the 
region of the heart is also useful. 



ENLARGEMENT OF THE VENTRICLES OF THE HEART. 

This is the result of overaction causing an excess of nutrition, the 
nutritive process appearing to go on more rapidly on account of the 
extra work which the heart is called upon to perform. In this way the 
heart is often greatly enlarged in bulk, and its operations seriously 
interfered with. Three kinds are classified : first, simple, when the 
walls of the heart or its divisions are thickened, without any diminution 
in the capacity of the cavities ; second, eccentric, or aneurismal, when 
the walls are thickened, and the cavities likewise enlarged; and, third, 
concentric, when the cavities are diminished in proportion to the thick- 
ening of the walls. The second of these is the most frequent; and any 
of them may affect a single cavity or the whole heart. The pulsations 
are frequently regular, but strong, sometimes even visibly raising the 
bedclothes, and the chest is bulged out over the part. 

Treatment. — Rest and freedom from exertions and emotions are 
proper means to be employed in such a case ; and usually, with care and 



FAINTING OR SYNCOPE. 361 

perseverance, the symptoms will be much alleviated. Stimulants must 
be avoided; coffee and tobacco are usually detrimental in such cases. 



SHRINKING OR ATROPHY OF THE HEART. 

A wasting of the heart's substance, arising from a deficiency in the 
supply of blood (nutrition). It is usually accompanied by general 
emaciation, and terminates in death. When the heart is examined after 
death, the tissues are found to have undergone a change. This is 
called "fatty degeneration." The treatment is to strengthen the system 
by tonics, especially iron and mix vomica, wholesome and nutritious 
diet, open air, exercise, sea bathing, etc. 



FAINTING OR SYNCOPE. 

This is a state of total or partial unconsciousness, occasioned by 
diminished action of the heart, causing less rapid circulation of blood 
through the brain. 

Causes. — The causes of it are various, and sometimes very peculiar, 
such as a particular smell; that of a rose, for instance, has been known 
to occasion it; certain objects presented to the sight; surprise, joy, fear, 
or any sudden emotion; loss of blood, or anything which tends to 
debilitate. 

Symptoms. — The first sensation of fainting is generally a singing 
in the ears; then the sight becomes confused, and all the senses 
deadened; a clammy sweat breaks out over the body, the countenance 
becomes deadly pale, and the limbs refuse to support the weight of the 
body, and the sufferer sinks to the earth helpless and motionless. 

Treatment. — Place the patient in a horizontal position; free the 
face, neck, and upper part of the chest from all tight clothing; let the 
fresh air play freely upon them, and sprinkle the face with cold water, 
holding to the nostrils from time to time some Volatile stimulant, 
such as hartshorn or ammonia. As soon as swallowing can be accom- 
plished, administer about thirty drops of spirit of wine, or sal volatile, 
in water. The after-treatment will of course depend on the cause. 

Persons subject to fainting should be careful in frequenting crowded 
rooms, or going anywhere where the air is bad. Tight dresses should 
be avoided; and no excitement be allowed. A well regulated diet, 



362 DISEASES OF ADULTS. 

cold bathing, and vegetable tonics will usually cure this distressing 
infirmity. 



DISEASES OF THE STOMACH. 

INFLAMMATION OF THE STOMACH OR ACUTE 

GASTRITIS. 

Inflammation of the mucous membrane of the stomach. 

Causes. — The corrosive poisons such as the mineral acids, corrosive 
sublimate, carbolic acid, copper, etc. ; indigestible food in the stomach ; 
alcohol in excess or irritating medicines ; exposure to cold, wet, and 
fevers. 

Symptoms. — Loss of appetite ; coated tongue ; bad breath ; vomiting ; 
fever; headache; burning sensation in the palms of the hands and the 
soles of the feet; pain and tenderness over the stomach; constipation 
or diarrhcea. 

When the result of poisons there are nausea; vomiting; cold, 
clammy skin; slight perspiration; low, weak pulse; intense heat and 
burning in the stomach; thirst; purging; and collapse. 

Prognosis. — In non-poisonous cases or a mild type the attack lasts 
about a week and usually terminates favorably. In poisoning cases the 
patient often dies from shock or exhaustion and not infrequently from 
starvation. Those who do recover are generally always troubled with 
gastric affections. 

Treatment. — When due to poisoning a physician should be called 
without delay and the stomach washed out and the proper antidote 
administered. (See Poisons and their Antidotes, page 611.) Ice 
internally and externally will afford relief. Milk and lime water should 
be administered after the stomach has been thoroughly emptied and 
other nutriment given by the rectum. 

Cases due to other causes are best relieved by emptying the stomach 
with an emetic followed after action by a brisk cathartic such as Epsom 
salts, Hunyadi water, or Apenta water, and the application of hot 
bran poultices, sprinkled with laudanum, to the seat of pain. After 
which the diet should be carefully selected — liquid diet at first, gradu- 
ally increased until the regular diet is resumed. The use of bitter 
tonics such as : tincture of nux vomica, five to ten drops, and Fairchild's 



MILK SICKNESS. 363 

essence of pepsin, one teaspoonful in a wineglass of water before each 
meal. 
Or:— 

Bicarbonate of Soda, 3 drams. 

Subnitrate of Bismuth, 2 drams. 

Chloroform Water, 3 ounces. 

Mix and add : — 

Peppermint Water, 1 ounce. 

Cherry-laurel Water, 2 ounces. 

Take a tablespoonful four times a day. 



MILK SICKNESS. 

Causes. — A disease chiefly confined to the West, where the cattle 
roam at large in the woods or over prairies, and eat food which poisons 
the milk. 

Symptoms. — Sickness at the stomach, weakness and trembling of 
the legs. There is vomiting and a peculiarly offensive breath. These 
symptoms continue for weeks, and are often all that are shown in this 
complaint ; but in some severer cases there are chills and flashes of heat, 
great oppression about the heart, anxiety, deep breathing, heat in the 
stomach, violent retching and vomiting, alarming heart action, and 
throbbing of the large vessels, and cold extremities. In most cases, the 
vomiting returns every hour or two, attended by a great burning at the 
pit of the stomach, the substance thrown up having a peculiar bluish- 
green color and a sour smell. As soon as this discharge takes place, 
the patient falls back upon the pillow, and lies easy until another 
paroxysm occurs. The tongue is covered with a whitish coat, and the 
bowels are obstinately costive. The pulse is weak and rapid. 

Treatment. — The treatment cannot vary much from that pursued 
for inflammation of the stomach. Some cathartic to move the bowels 
should be given. 

WATER BRASH. 

Water brash consists in a discharge from the stomach, generally 
in the morning, of a thin fluid, sometimes insipid. A burning heat or 
pain of the stomach attends it, and seems to cause the discharge. The 
amount thrown up varies from a spoonful to a pint. 

Cause. — It is due to acid indigestion. 



364 DISEASES OF ADULTS. 

Treatment. — Ten or fifteen drops of ammonia water in half a 
tumblerful of cold water will quiet the distress and stop the discharge. 
The best remedy for this discharge is the subnitrate of bismuth, taken 
at meal times, three times a day, in 30-grain doses. The tincture 
of nux vomica in 5-drop doses is good. The blood should be im- 
proved by tonics containing iron, and the food should be nourishing 
and digestible. 

NAUSEA AND VOMITING. 

A sensation of sickness associated with vomiting. 
Causes. — Although the feeling of nausea itself is referred to the 
stomach, and may be due to causes connected with that organ, it may 
arise from various causes, as excess in eating and drinking, and foulness 
or weakness of the stomach. It also frequently originates in disorder 
in other and distant parts of the body. 

Treatment. — Calomel, one half to one fourth grain, and bicarbonate 
of soda, two grains, every two hours for eight or ten doses. Three 
hours after the last dose take a purgative dose of Hunyadi water. 

After the bowels have been thoroughly moved, the use of pepsin, 
bismuth, and strychnia is in order. 

When the nausea and vomiting are so persistent that these remedies 
cannot be retained their administration may be preceded by the follow- 
ing :— 

Carbolic Acid, 4 grains. 

Bismuth Subnitrate, 2 drams. 

Glycerine, 3 drams. 

Peppermint Water, to make 3 ounces. 

Mix. Give one tablespoonful every two hours until relieved. 

Or:— 

Bismuth Subnitrate, 160 grains. 

Dilute Hydrocyanic Acid, 30 drops. 

Cinnamon Water, 2 ounces. 

Mix. Give one teaspoonful every two hours. 

The nausea and vomiting of drunkards is relieved by : — 

Strychnia Nitrate, % grain. 

Fowler's Solution of Arsenic, 20 drops. 

Glycerine, 3 drams. 

Water, to make 2 ounces. 

Mix. Give one teaspoonful every four hours. 



DYSPEPSIA. 365 

CRAMP OR SPASM OF THE STOMACH OR GASTRALGIA. 

Violent paroxysms of pain in the stomach. 

Causes. — A form of neuralgia of the stomach; a result of neuras- 
thenia ; gastric cancer, or ulcer ; malaria ; anaemia ; syphilis ; indiscre- 
tions of diet; worry; menstrual disorders; excessive use of tobacco. 

Symptoms. — Sudden, severe, griping pains in the stomach ; f aint- 
ness; shrinking of the countenance; intermittent pulse; cold hands and 
feet. The pain is often so severe as to cause outcries from the patient. 
Some relief is felt from pressure on the stomach. The pain usually 
subsides in half an hour. Exhaustion follows the attack. When 
the pain suddenly subsides there are often vomiting or eructions of 
gas or thin fluid like water, mild perspiration and flow of reddish 
urine. The pain is relieved by taking food. 

Prognosis. — Not dangerous but may be persistent. 

Treatment. — The paroxysm is relieved by: — 

Chlorydine, 20 to 30 drops. 

Repeat in one hour if necessary. 

If the attack is mild give: — 

Antipyrine, 10 grains. 

and apply a hot water bag over the stomach. 

Or:— 

Spirit of Chloroform, 1 dram. 

Compound Spirit of Lavender, 1 dram. 

This is useful to dispel gas and relieve distention of the stomach. 

During the intervals the cause is to be combated. For nervous 
causes, rest, freedom from worry, outdoor exercise, and care that nc 
irritating food is taken. 



DYSPEPSIA OR INDIGESTION. 

This is one of the most common ailments to which mankind is 
subject. 

Causes. — Accidental fits of indigestion are of frequent occurrence, 
and are caused by overloading the stomach with food, and indulging 
freely in wines, spirits, or other intoxicating liquors. Confirmed or 
chronic indigestion may depend on debility or want of tone of the 



366 DISEASES OF ADULTS. 

stomach, or it may be caused by the lining or mucous membrane of this 
organ being in a state of irritation, or chronic inflammation. One of 
the most frequent causes of indigestion is improper mastication of the 
food; such food is bolted, instead of being reduced to a pulp, thereby 
presenting to the digestive organs a hardened mass, difficult to digest. 
Another cause is habitual inattention to diet, both with regard to the 
quality and quantity of food, irregular meals, drinking large quantities 
of warm, relaxing fluids, and using malt liquors too freely. A third 
cause is insufficient exercise; a fourth cause, impure air; and, beside 
these, there are numberless other causes, which in a greater or less 
degree exercise their baneful influence upon the stomach. 

Symptoms. — One of the most frequent signs of indigestion is loss 
of appetite, perhaps even an absolute repugnance and disgust at the 
very thought of eating. Sometimes the appetite is capricious and 
uncertain, or it may be ravenous. Sometimes nausea comes on imme- 
diately after the food is swallowed; and sometimes, without any nausea, 
the food is ejected by vomiting. There is usually an obscure feeling 
of uneasiness, fullness, distention, and weight in the region of the 
stomach, occasionally amounting to pain, or even severe pain, with 
flatulence and eructation. Some persons suffer pain when the stomach 
is empty, others immediately after taking food, or the pain may not 
begin for two or three hours after a meal, and then continue for some 
hours. Sometimes the pain comes on at uncertain intervals accompanied 
by a sensation of distention, much anxiety, and extreme restlessness. 
Costiveness is a very frequent concomitant of dyspepsia, but sometimes 
it is attended by diarrhoea. 

Among the innumerable disorders that are produced by dyspepsia 
are palpitation of the heart, irregularities of the pulse, asthma, pain 
in the head, with the loss of mental energy, and some confusion of 
thought. One of the worst of the occasional concomitants of dyspepsia 
is that state of mind which is known as hypochondriasis. There is 
languor, listlessness or want of resolution, with an apprehension of 
some great evil in the future. Such persons are particularly attentive 
to the state of their own health, and, from any unusual feeling, perhaps 
of the slightest kind, they apprehend great danger, or even death itself. 

Kinds of Dyspepsia. 

I. Irritative Dyspepsia, as the name implies, is caused by one or 
more of the many possibilities of irritation of stomach resulting from 



DYSPEPSIA. 367 

coarse, unchanged diet, or alcoholic excesses. One of the most marked 
symptoms is vomiting; and the tongue is pointed, small, and red. 

II. Acid Dyspepsia, marked by water brash, sour stomach, with the 
acidity extending to the intestines and the urine. 

III. Flatulent Dyspepsia, accompanied by very great development 
of gas in the abdomen, dizziness, worry, and hypochondriasis. 

IV. Nervous Dyspepsia is the common form seen among business 
and professional men. It is caused largely by rapid eating and 
sedentary life. The symptoms are sleepiness after eating; dizziness; 
sleepless nights ; loss of memory ; headache ; and general nervousness. 

Prognosis. — The outlook is favorable provided proper treatment 
and good hygiene are observed. Otherwise the duration may be 
indefinite. 

Treatment. — Before we proceed to give the remedies applicable to 
this disorder, we lay before our readers what is of equal consequence, 
both as regards prevention and cure — viz., diet and regimen. Rise 
early; sponge the body freely with cold water; eat a slice or two of 
stale bread, together with a piece of broiled beefsteak cooked rare, 
f or breakfast. After a short rest, exercise should be taken for two 
hours or upwards. The dinner hour should not be earlier than four or 
five hours after breakfast, and the best time in the day for this meal 
is the noon hour. The food should be taken plain without sauces. 
Roast beef or mutton are the best of all meats, both as regards nourish- 
ing properties, and the ease with which they are digested. Avoid coffee ; 
buttermilk or koumyss may be used instead. Bitter tonics may be 
used, and a pepsin powder after each meal. After dinner, rest and 
quiet for an hour are desirable. About four or five hours after dinner 
a cup of tea with stale bread and good butter, with fresh or preserved 
fruit, may be eaten sparingly. Retire early. This mode of living 
will generally render a person exempt from habitual indigestion; never- 
theless, in spite of these precautions, occasional attacks of this derange- 
ment will make themselves felt. 

Starchy, sweet, and fat food must be avoided. The food must be 
well chewed, and only small quantities taken at a time. Liquids should 
be taken in only very small quantities and alcoholic stimulants should 
not be taken in any quantities. 

As a medicinal help to digestion, taka-diastase taken in 2 to 4 grain 
doses after meals is very beneficial. 



368 DISEASES OF ADULTS. 

Or:^ 

Pepsin, i dram. 

Dilute Hydrochloric Acid, 4 drams. 

Glycerine, 4 drams. 

Cherry-laurel Water, 2 ounces. 

Take one teaspoonful in water before each meal. 

Flatulency, wind on the stomach, may be relieved by the use of 
purified animal charcoal in the form of tablets. One allowed to dis- 
solve in the mouth occasionally. 

Heartburn and the burning sensation in the stomach are benefited 
by:- 

Subnitrate of Bismuth, 20 grains. 

Aromatic Powder, 5 grains. 

One such dose as required. 

Vomiting is present in Irritative Dyspepsia. (See "Nausea and 
Vomiting," page 364.) 

Great benefit is felt from drinking from a half to one pint of hot 
water an hour before each meal. This has the effect of washing or 
irrigating the stomach and exciting it to healthy action. 

Constipation is frequently a troublesome and dangerous attendant. 
(See "Constipation," page 370.) 

GASTRIC ULCER OR ULCER OF THE STOMACH. 

The cause of this condition is not quite settled. It attacks young 
women more frequently than men. Those who are anaemic, over- 
worked, and underfed, and those who have suffered injury in the region 
of the stomach are most susceptible to this disease. 

Symptoms. — Disturbances of digestion associated with pain at the 
pit of the stomach. This pain is of a burning, boring, or gnawing 
character, increased by taking food, and may be felt at once after eating, 
or an hour or two after the meal. 

Pain is frequently felt in the back. Vomiting of blood is quite 
constant. The patient may be emaciated, or appear well nourished. 
Blood is sometimes found in the stools. The disease is of a chronic 
character and frequently leads to 4 perforation of the stomach wall. 

Prognosis. — The patient may recover under favorable treatment; 
but the greatest danger arises from perforation of the bowel, which 
requires prompt surgical attention. 

Treatment, — Rest in bed should be enforced. Feeding should be 



CANCER OF THE STOMACH. 369 

conducted through the rectum to give the stomach a complete rest, or 
the patient should partake by the mouth of only skimmed milk, two 
ounces, and limevvater, one ounce, every two hours. The pain is relieved 
by use of anodynes. The hemorrhages are controlled by the administra- 
tion of acetate of lead, one or two grains twice daily, or a capsule con- 
taining one or two grains of stypticin three times daily. 

Silver nitrate, one fourth grain every four hours, has a beneficial 
effect upon the ulcer, but it is useless here to further describe the 
treatment, which can be carried out only under the intelligent guidance 
of a physician. 



GASTRIC CANCER OR CANCER OF THE STOMACH. 

This condition occurs more commonly in men after the fortieth 
year. 

Causes. — Heredity; gastric ulcer; and alcoholism. Scientists now 
believe it to be due to a cancer germ. 

Symptoms. — It develops slowly, with gradual loss of strength, 
indigestion, fermentation, dyspepsia, and foul breath. There is vomit- 
ing, after meals, of partially digested food and blood which is more or 
less altered, giving the vomit a black or coffee ground appearance. A 
new growth may be felt over the region of the stomach, at which point 
there is much tenderness amounting to pain which is dull, heavy, and 
increased by pressure (even by the weight of the clothing) and after 
eating. 

The patient is emaciated, has some fever, the bowels are constipated 
and, because of the presence of blood, the stools are black and tar- 
like. Dropsy of the lower extremities, particularly of the ankles, is 
present. 

Prognosis. — The disease terminates usually within a year after its 
recognition. The patient is melancholy, but the mind is clear to the 
end. Medical treatment is of little avail. Surgical intervention fre- 
quently prolongs life. 

Treatment. — This is palliative and is directed towards sustain- 
ing the strength of the patient and allaying pain. The food must be 
predigested. The best form is peptonized milk. This is conveniently 
prepared by adding five grains of the extract of pancreas and fifteen 
grains of bicarbonate of soda to one pint of milk. The mixture is 



370 DISEASES OF ADULTS. 

then placed in a vessel of water and kept at a temperature of about ioo 
or 1 1 5 Fahrenheit for one hour. Beef, eggs, and similar food may be 
peptonized. (See "Food for the Sick," page 281.) 

In cases where the stomach is not able to retain food, rectal feeding 
must be resorted to. (See "Nursing," page 235.) 

Digestion is improved and fermentation of the food in the stomach 
is prevented by: — 

Sulphate of Strychnia, y 2 grain. 

Dilute Hydrochloric Acid, 4 drams. 

Infusion of Gentian, to make 5 ounces. 

A tablespoonful in water before each meal. 

Bad breath may be relieved by charcoal tablets, or by from %. to 
J of a grain of carbolic acid in water. 
No stimulants should be used. 



DISEASES OF THE BOWELS. 

CONSTIPATION. 

When there is an undue retention of the contents of the bowels, 
their contents become hard and are expelled with difficulty and some- 
times with pain. 

Causes. — Neglect of the usual time of going to stool, extraordinary 
heat of the body, copious sweats, taking food that is dry, heating, and 
difficult of digestion; sedentary life, or a diseased state of the liver or 
spleen, sometimes from stricture in the rectum. 

Treatment. — The first thing to be done is to establish the habit 
of trying to evacuate the bowels every day at a certain hour; the best 
time for most people is just after breakfast. It matters not if the 
bowels do not act; the practice of attempting should be persisted in, 
and in time it will break up the confined state of the bowels. Adopt a 
diet free from all astringents, taking care especially that there is no 
alum in the bread. Let the food consist of a due admixture of meat 
and vegetables for dinner; the beverage, water. For breakfast stale 
bread or dry toast, with a moderate quantity of butter, honey, fish, or 
bacon; cocoa is, perhaps, preferable to tea or coffee; porridge made of 
Scotch oatmeal. Regular exercise, either walking or horseback riding-, 
should be taken. Apples, pears, stewed prunes, raisins, gruel with 



INTESTINAL INDIGESTION. 371 

currants, broths with spinach, leeks, and other soft pot-herbs are 
excellent laxatives. If the above mode of living fail to relax the 
bowels, inject a warm water enema. 

Hunyadi Janos water is a very beneficial aperient. 
On- 
Bicarbonate of Soda, . 2 drams. 

Tincture of Nux Vomica, 4 drams. 

Tincture of Capsicum, 1 dram. 

Tincture of Rhubarb, 1% ounces. 

Compound Infusion of Gentian, ... to make 6 ounces. 
Take a half-tablespoonful in water after each meal. 

Or:— 

Fluid Extract of Cascara Sagrada, . . 1 ounce. 

Tincture of Nux Vomica, Y / 2 ounce. 

Syrup of Ginger, y 2 ounce. 

Infusion of Sarsaparilla, to make 3 ounces. 

Take a teaspoonful in water three times a day. 

For beneficial mineral and aperient waters, see Hydrotherapy. 



INTESTINAL INDIGESTION. 

Defective and imperfect digestion of food after it has passed from 
the stomach. 

Causes. — Imperfect diet; overeating; worry; mental weariness; 
abuse of tobacco and stimulants ; irregular hours ; sedentary occupation ; 
diseases of the stomach, liver, or intestines; malaria; deficiency of 
intestinal secretions; or loss of tone of the intestines. 

Symptoms. — Abdominal pain; distention of the abdomen; both 
occurring some hours after meals (these symptoms are delayed much 
longer after eating than are similar signs of stomach indigestion) ; 
emaciation ; anaemia ; nervousness; flatulency; coated tongue; loss of 
appetite; diarrhoea; and headache. Sometimes the liver is involved, 
then there are jaundice, dark-colored urine, and light-colored, clayey 
stools. In chronic cases the pain is first felt in from two to six hours 
after eating; difficulty of breathing; constipation; and dry, harsh skin 
are manifested. 

Treatment. — The pain is to be relieved by hot applications and a 
cathartic to expel the irritating matter. 



372 DISEASES OF ADULTS. 

Calomel, -J grain. 

Bicarbonate of Soda, 2 grains. 

Powdered Ipecac, 1-6 grain. 

Sugar of Milk, 3 grains. 

Make six such powders and take one every two hours. 

This is to be followed by a full dose of Epsom salts, Rochelle salts, 
Hunyadi Janos water, or Apenta water. 
The intestines are then stimulated by: — 

Tincture of Nux Vomica, 2 drams. 

Dilute Hydrochloric Acid, 4 drams. 

Compound Tincture of Cardamom, 4 drams. 

Essence of Pepsin, to make 3 ounces. 

A teaspoonful every three hours in water. 

Or, in more severe cases, give : — 

Phosphate of Soda, 1 ounce. 

Dilute Phosphoric Acid, 4 drams. 

Syrup of Lemon, 1 ounce. 

Chloroform Water, 3 ounces. 

Peppermint Water, 3 y 2 ounces. 

Take a tablespoonful in a wineglass of water after each meal. 
In chronic cases much benefit is derived from aperient waters. 
See Hydrotherapy, 

The following pill often produces excellent results in -chronic 
cases : — 

Arsenate of Soda 1-20 grain. 

Sulphate of Strychnia, 1-32 grain. 

Pure Pepsin, 2 grains. 

Take one such pill after each meal. 

The diet must be restricted to easily digested food, such as milk, 
eggs, and beef. 

DIARRHOEA. 

Causes. — The causes which produce diarrhoea are indigestible 
food, or food taken in too great quantities; acid fruits, irritating sub- 
stances taken into the stomach; the abuse of active purgative medicines; 
the application of cold to the body; and the suppression of perspiration. 

Symptoms. — This disease consists in a copious and frequent dis- 
charge of matter from the bowels, accompanied by griping. There 
is a sense of weight and fullness in the lower part of the stomach, 
attended with a murmuring noise, arising from the presence of a great 



DIARRHCEA. 373 

collection of wind. This feeling is relieved after every evacuation 
which takes place and is renewed before a second ensues. In addi- 
tion to these symptoms, the patient is troubled with nausea, vomit- 
ing, and, if the purging be not quickly arrested, by great exhaustion 
and depression of the vital powers, accompanied by more or less colicky 
pain. It is distinguished from dysentery by the absence of blood in the 
motions. The appearance of the stools in the commencement of the 
disease is sometimes thinner than natural, in consequence of a large 
quantity of fluid being poured out by the intestines. They are some- 
times slimy and of a green color; sometimes they are yellow, and 
sometimes of a dark brown, accompanied by a very fetid smell. As 
the disease advances they become very watery, and similar to coffee 
grounds; the strength rapidly fails, the countenance turns pale, the 
skin is dry ind stiff, great emaciation takes place, and dropsy frequently 
ensues. 

Treatment. — In the treatment of this disease, attention must be paid 
to the cause which produces it, and the remedies administered accord- 
ingly. If it is caused by indigestible food, or should the stools be 
scanty and frequent, and accompanied by some degree of bearing down, 
four or six drams of castor oil, with five drops of tincture of opium, 
will afford great relief. If it is caused by the abuse of purgative 
medicines, they must be discontinued, and the following mixture 
administered : — ■ 

Tincture of Rhubarb, 1 ounce. 

Tincture of Opium, 30 drops. 

Spirit of Lavender, 4 drams. 

Cinnamon Water, 5 ounces. 

Make a mixture, and take two tablespoonfuls every four or six 
hours. 

If it has proceeded from the application of cold to the surface of the 
body, or the suppression of perspiration, every effort must be made to 
restore the secretion by the administration of ten grains of Dover's 
powder, taken in a little gruel or water. 

The following is a good mixture: — 

Prepared Chalk, 3 drams. 

Spirit of Lavender, 2 drams. 

Compound Tincture of Cardamom, 2 drams. 

Tincture of Opium, y 2 dram. 

Cinnamon Water, 6 ounces. 



374 DISEASES OF ADULTS. 

Make a mixture, and take two tablespoonfuls every three or four 
hours until the diarrhoea ceases. 

Another line of treatment for all forms of diarrhoea is to free the 
bowels from offending matter by a full dose of castor oil ; then take, 
every three hours, a pill containing: — 

Extract of Opium, J4 grain. 

Camphor, 3 grains. 

Or:— 

Insert a 1 -grain opium suppository into the rectum once, twice, 
or thrice, daily. 

When it arises from ulceration of the intestines, as often happens 
in consumption and other protracted diseases, the most effectual astrin- 
gents, in addition to those already recommended, should be employed, 
such as catechu, kino, alum, logwood, and tannin. The following is a 
good mixture in these cases : — 

Chalk Mixture, 5 ounces. 

Tincture of Catechu, 4 drams. 

Tincture of Kino, 3 drams. 

Syrup of Poppies, 2 drams. 

Tincture of Opium, 30 drops. 

Make a mixture, and take two tablespoonfuls three or four times 
a day. 

The diet in these cases should consist of sago, arrowroot, and rice 
puddings, made with or without milk. It will be necessary for those 
persons who are subject to frequent attacks of this complaint, either 
from a peculiar weakness or irritability of the bowels, to live temperately 
and abstain from unwholesome food. 

Eclectic Treatment for Diarrhoea. 

If caused by cold or obstructed perspiration, keep the patient warm ; 
drink freely of astringent herb teas ; use the tepid bath, and wear flannel 
next the skin. A little snakeropt tea will also be found useful. If 
there is much griping, a hot fomentation of garden mint should be 
applied to the stomach. Speedy relief has been effected by taking 
twelve drops of laudanum in half a gill of the best brandy. Repeat, 
if necessary, in about an hour. 

In obstinate cases, the jelly of slippery elm and blackberry, in equal 
parts, mixed with a little powdered ginger or cinnamon may be used. 
For chronic looseness, the following decoction is very good : — 



DYSENTERY. 375 

Bistort Root, bruised, 3 ounces. 

Water, 1 quart. 

Boil twenty minutes; then add: — 

Cloves, bruised, I ounce. 

Cranesbill and Wild Mint, of each, y 2 ounce. 

Catechu, 2 drams. 

Boil ten minutes longer, strain, add : — 

Loaf Sugar, 1 pound. 

Dose, three tablespoonfuls three or four times a day. 
The following has also been used with excellent results : Take equal 
parts of tincture of rhubarb, spirits of camphor, essence of peppermint, 
and laudanum. Dose, for an adult, one teaspoonful every hour if 
necessary; less according to age of the patient and severity of the 
disease. 

DYSENTERY. 

A disease accompanied by frequent and scanty discharges from 
the bowels, and tenesmus or great bearing down of the rectum. The 
stools are mucous, bloody, or slimy, and contain little or no fecal matter. 

Causes. — The causes which produce this disease are a cold and 
moist state of the atmosphere, quickly succeeded by heat; the suppres- 
sion of the perspiration,, whereby the blood is thrown from the external 
upon the internal vessels; immoderate use of spirituous liquors, 
unwholesome .food, exposure to noxious exhalations, or to the effluvia 
arising from the bodies of persons laboring under the disease. 

It frequently appears in hospitals which are not properly ventilated, 
and other places where a number of sick persons are crowded together ; 
while in situations where great attention is paid to ventilation and 
cleanliness, it seldom extends beyond the individual in whom it 
originates. 

Symptoms. — This disease is ushered in by all the concomitants 
of inflammatory fever — such as cold shivering succeeded by heat of skin, 
frequency of pulse, loss of appetite, nausea, and diarrhoea. This stage 
is quickly followed by severe griping pains, and pain in the abdomen, 
frequent desire to go to stool, accompanied by straining and painful 
bearing down of the rectum — the evacuations consist of more or less 
fecal matter. The stools frequently vary in appearance, being some- 
times pure mucus, or mucus streaked with blood and containing pus, 



376 DISEASES OF ADULTS. 

and it not unfrequently happens that pieces of membrane, arising 
from ulceration of the lining of the intestines, are seen floating in the 
dejections. The stools number from 5 to 20 or more in 24 hours. 

Treatment. — Confinement to bed, the patient using a bedpan; the 
stools thoroughly disinfected with chloride of lime. The diet must be 
fluid, non-irritating, and nutritious, such as milk and limewater; white 
of egg, alone, or with milk and brandy; beef and mutton broths; 
chicken soup; oyster soup; clam juice. 

Castor oil, two to four tablespoonfuls in brandy or whisky; ten to 
twenty drops of laudanum may be added with great benefit; or Epsom 
or Rochelle salts in two teaspoonful doses every hour until thorough 
movement. 

The pain and excessive movements may then be controlled by the 
insertion (into the rectum) of a 1 -grain opium suppository every four 
hours. 

Hope's camphor mixture works well in many cases. It is as fol- 
lows : — 

Nitrous Acid, 1 dram. 

Camphor Mixture, 8 ounces. 

Mix and add : — 

Tincture of Opium, 40 minims. 

Mix and take one fourth of this mixture every four hours. 
The bowels should be washed out with salt solution twice daily : 
a teaspoonful of table salt dissolved in a pint of hot water. 
Chronic cases are benefited by the following: — 

Tannalbin, 1 ounce. 

Ichthalbin, 1 ounce. 

Sugar of Milk, 30 grains. 

Mix and divide into thirty powders. 

Directions : One three times daily before meals. 

When convalescence is established, such reconstructives as cod liver 
oil, and elixir iron, quinine, and strychnine, in one to two teaspoonful 
doses after meals, are efficient. 

CHOLERA MORBUS. 

This is a disease prevalent in hot, damp weather. From the great 
amount of bile secreted, it is also called Bilious Cholera. 

Causes. — Excessive heat, sudden atmospheric changes, wet feet, 
indigestible food, and unripe fruits. 



CHOLERA MORBUS. 377 

Symptoms. — This disease begins with sickness and distress at the 
stomach, succeeded by violent gripings with vomiting of thin, dirty 
yellowish, whitish, or greenish fluid. The contents of the upper bowels 
may be vomited. The nausea and distress continue between the vomit- 
ing and purging, and the pain at times is intense. The pulse is rapid, 
soon becoming small and feeble, the tongue dry, the urine high colored, 
and there is much thirst, though no drink can be retained on the 
stomach. 

Treatment. — Apply a large mustard poultice over the stomach 
and liver. Give large draughts of warm teas, by which means the 
stomach will be cleansed of all its solid contents. Warm injections 
must be given frequently, and hot bricks applied to the feet, while the 
whole body should be swathed in warm flannels and hot water bottles 
applied to keep up the body temperature. Hot brandy, in which is a 
dose of cayenne, is excellent to quiet the vomiting and griping. A 
few drops of laudanum in the injections may be given, if the pain is 
excessive. 

Or:— 

Extract of Opium, %. grain. 

Camphor, 3 grains. 

Make into one pill. Give one such pill every three hours for an 
adult. 
Or:— 

Morphine Sulphate, 1 grain. 

Quinine Sulphate, 1 dram. 

Aromatic Sulphuric Acid, enough to dissolve. 

Magnesia Sulphate, 2 ounces. 

Peppermint Water, to make 4 ounces. 

Shake. Take one to two teaspoonfuls in a glass of water, after stools. 

This is known as the "Army Hospital Mixture." Diet: Milk and 
raw eggs. Keep patient in recumbent position. 

If these remedies do not afford immediate relief a physician should 
be summoned without delay. 

Eclectic Treatment for Cholera Morbus. 
No time must be lost in treating the severe stages of this disease. 
Give the patient copious drinks of whey, warm barley water, thin 
water gruel, or weak chicken broth. Bathe the feet and legs in warm 
saleratus water, and apply warm fomentations of hops and vinegar to 
the bowels. In addition to these, apply a warm poultice of well stewed 
garden mint, or a poultice of mustard and strong vinegar will be found 



378 DISEASES OF ADULTS. 

of much service. The vomiting and purging may be stopped by the 
following : — 

Ground Black Pepper, i tablespoonf ul. 

Table Salt, i tablespoonf ul. 

Warm Water, y 2 tumblerful. 

Cider Vinegar, y 2 tumblerful. 

Dose, a tablespoonful every few minutes. Stir and mix each time 
until the whole is taken. 

Nourishing diet should be taken by the patient. A wineglassful 
of cold camomile tea, once or twice a day, would be very beneficial, 
as would ten drops of elixir of vitriol, three or four times a day, or a 
tea made of black or Virginia snakeroot. Flannel should be worn 
next the skin, and the warm bath should be frequently resorted to. 

COLIC. 

Colic is a name given to several varieties of disease characterized 
by severe pain of the bowels, with distention or flatulence, but without 
looseness or diarrhoea. Physicians distinguish several varieties of this 
complaint: Spasmodic, in which the principal symptoms are sharp 
and spasmodic pains about the navel; that occasioned by indigestible 
food, gas, or acrid matter in the intestines; bilious, when accompanied 
by vomiting of bile, or by obstinate costiveness; lead or Devonshire 
colic, which is due to the poison of lead. 

Causes. — Among the most frequent causes may be named worms, 
poisonous or unwholesome substances, indigestible food, gout, rheuma- 
tism, intense cold, acid fruits, and unripe vegetables. 

Symptoms. — The symptoms of colic, in general, are distention of 
the lower region of the belly, with twisting pain, and very commonly 
vomiting and costiveness. 

PAINTERS' COLIC. 

Lead or painters' colic is characterized by obstinate costiveness, 
and vomiting of bile. The pain comes on in paroxysms. The spasms 
gradually become more violent, and, if not alleviated, become 
unbearable. 

Treatment. — Give immediately from thirty to forty drops of lau- 
danum and apply heat over the abdomen. Hot drinks containing 
peppermint, spearmint, and composition tea generally afford relief. 



COLIC. 379 

For the treatment 'of paralysis, or palsy arising from the absorption 
of lead, which is generally confined to the wrists, use galvanism, 
friction, and shampooing, with chalybeate waters. Those engaged in 
the manufacture of lead, or in occupations in which one or other of its 
preparations are frequently handled, may generally escape its baneful 
effects by strict attention to cleanliness. They should never take their 
meals where they work, or with unwashed hands. Let them eat fat 
meat, and butter, and take acidulous drinks, especially those rendered 
so by sulphuric acid. The men employed at the Birmingham white 
lead works have been almost free from this disease, to which they 
were much subject before, since they have mixed a little of the above 
acid with their molasses beer. From the first attack of lead colic 
patients generally recover; but unless they change their occupations, 
or observe the above precautions with scrupulous care, the attacks are 
repeated, each time with greater violence, and they will become, 
eventually, miserable cripples. 

WIND COLIC. 

Wind colic is a severe and distressing pain in the bowels ; sometimes 
a stoppage, and swelling about the pit of the stomach and the navel. 
The complaint may be caused by weakness in the digestive organs, by 
indigestible food, unripe fruit, or costiveness. 

Treatment. — If the pain is caused by having eaten anything indi- 
gestible, an emetic should be immediately taken. If this does not bring 
relief, a dose of salts, or sweet tincture of rhubarb, may. If there is no 
sickness at the stomach, a little ' essence of peppermint in water, or 
brandy, or gin in hot water, may be sufficient to expel the wind and 
give relief. If there be costiveness, and continued pain, a stimulating 
injection should be given. 

BILIOUS COLIC. 

Bilious colic is a painful disease. There is griping, twisting, tearing 
pain about the navel, or sometimes over the whole abdomen. 

Causes. — It is caused by irritating articles taken into the stomach, 
the presence of bile in the stomach, long exposure to cold, torpid liver 
and skin, great unnatural heat, etc. 

Symptoms. — It comes and goes by paroxysms. Sometimes the 
abdomen is contracted, at other times enlarged, and stretched like a 



380 DISEASES OV ADULTS. 

drumhead. At first the pain is relieved by pressure, but after a time 
the abdomen grows tender to the touch. There is thirst and heat, and 
vomiting of bilious matter from the stomach. In the worst cases, the 
pulse is small, the face pale, the features are shrunk, and the whole 
body is covered with a cold sweat. 

Treatment. — Administer an active cathartic immediately. Give 
a mixture of: — 

Pulverized Camphor, 4 grains. 

Cayenne, 1 grain. 

White Sugar, 1 scruple. 

This, divided into eight powders, and given once in fifteen minutes, 
will relieve the pain, at the same time a mustard poultice should be 
laid upon the abdomen. If the pain does not yield, give a teaspoonful 
of paregoric. The sickness of stomach may be allayed by hot draughts 
in which are a few drops of laudanum; one drop of croton oil in a 
crumb of bread will often purge successfully; or castor oil and spirits 
of turpentine, equal parts, in two tablespoonful doses, may be used 
before trying the other. A warm bath is good, and bottles filled with 
hot water, placed at the feet and sides, to promote perspiration. 

Eclectic Treatment for Colic. 

A decoction of equal parts of skullcap and high cranberry bark, 
to which is added a tablespoonful of the compound tincture of Virginia 
snakeroot, has been found very useful. Apply over the stomach and 
bowels hot fomentations of wormwood and boneset, or hops, stra- 
monium leaves, or hops and lobelia. 

In flatulent colic the legs should be bathed in warm water, and 
poultices of mustard or hot salt placed over the bowels and stomach. 
The bowels may be opened with a dose of castor oil, and ginger or 
peppermint tea may be drunk freely. To ease the pain, from thirty 
to sixty drops of paregoric may be given. In very severe cases, a 
mixture compounded of equal parts of laudanum, tincture of camphor, 
and essence of peppermint, in teaspoonful doses, may be given. In 
some cases a teaspoonful of spirits of turpentine, taken with a tea- 
spoonful of castor oil, has been found to give immediate relief. For 
painters' or lead colic, the following is highly recommended : — 

Sulphate of Magnesia, y 2 pound. 

Powdered Alum,. 1 ounce. 

Sulphuric Acid, iy 2 drams. 

Boiling Water, iy 2 pints. 



PILES. 381 

Mix. Dose, a tablespoonful in a wineglassful of water; repeat 
every hour until it operates upon the bowels. To prevent the acid 
from injuring the teeth, the solution may be sucked through a quill 
or a glass tube. After the bowels have been freely opened, the medicine 
should be continued for weeks or months, in doses sufficient to produce 
one or two passages every twenty-four hours. The sulphuric acid, by 
uniting with the oxide of lead in the system, forms the sulphate of 
lead, which is a harmless salt. 

The following is recommended to be taken by persons who are 
exposed to the bad influence of lead : — 

Elixir Vitriol, T / 2 ounce. 

Tincture of Prickly Ash Berries, 1 ounce. 

Dose, a teaspoonful in a gill of water, and repeat three or four 
times a day. 

PILES OR HEMORRHOIDS. 

These consist of small tumors, situated on the extremity of the 
rectum. The piles are usually accompanied by a sense of weight in the 
back, loins, and lower part of the abdomen, together with pain in the 
head, sickness at the stomach, and flatulence in the bowels. If the 
tumor break, a quantity of blood is voided, and considerable relief from 
pain is obtained; but, if they continue unbroken, the patient experiences 
great pain. 

Treatment. — The following treatment will generally prove bene- 
ficial : — 

Confection of Senna, 1 ounce. 

Flowers of Sulphur, 1 ounce. 

Jalap, in powder, 1 dram. 

Balsam of Copaiba, y 2 ounce. 

Ginger, in powder, ]/ 2 dram. 

Cream of Tartar, y 2 ounce. 

Syrup of Ginger, a sufficient quantity to form the 
whole into an electuary. 

Mix. Take a teaspoonful every three hours, until the bowels are 
freely open. At the same time make use of the following lotion : — 

Goulard's Extract, 3 ounces. 

Laudanum, y 2 ounce. 

Mix and apply to the parts repeatedly. When the piles are very 
painful and swollen, the patient should sit over steaming hot water. 



382 DISEASES OF ADULTS. 

Either of the following may be used to advantage: — - 

Powder of Oak Galls, i ounce. 

Elder Ointment, i ounce. 

Mix and anoint the parts night and morning. 

Sublimed Sulphur, y 2 ounce. 

Cream of Tartar, iy 2 drams. 

Confection of Senna, i ounce. 

Syrup sufficient to form an electuary. 

A teaspoonful to be taken at bedtime. 

The parts should be bathed with cold water after each evacuation, 
then dried and bathed again with witch hazel. At bedtime insert 
the following suppository into the rectum: — 

Cocaine, y% grain. 

Extract of Hyoscyamus, i grain. 

Zinc Oxide, 3 grains. 

Mix and make into one suppository. 



FALLING OF THE BOWEL. 

Prolapse of the rectum most frequently occurs with children and 
aged persons, though it takes place at all ages, and commonly in 
connection with piles, irritation from worms, or stone in the bladder; 
much straining of the bowels at stools will also occasion it. 

Treatment. — The bowel may be returned without difficulty, by 
means of gentle pressure with the fingers, covered with oil. If allowed 
to remain down long, it will become swollen, congested, and require 
the aid of a physician. Children so affected should have their bowels 
kept in a lax state with gentle aperients, and they should not be suffered 
to remain long on the stool; the loins should also be bathed with cold 
water; and an enema, consisting of a grain of sulphate of iron, dissolved 
in an ounce of rain water, should be thrown into the bowels after each 
motion. 

INFLAMMATION OF THE PERITONEUM OR PERITONITIS. 

This is an exceedingly painful and dangerous disease, from its 
extent and connection with important organs. It may exist either as 
an acute or chronic disease. 



FISTULA. 383 

Causes. — Its causes are various, as cold, mechanical injuries of the 
peritoneum, the development of tumors, etc. Women in childbed are 
peculiarly liable to it. 

Symptoms. — There is usually great pain, tenderness and board-like 
hardness of the abdomen, accompanied with fever, and a frequent pulse. 
Sometimes, at first, the pain is confined to one spot; but it generally 
soon extends over the whole of the abdomen. It is very severe, and 
much increased by any motion, even coughing, sneezing, or drawing 
a long breath. Even the weight of the bedclothes is sometimes unbear- 
able. The pain is acute and cutting, and sometimes occurs in 
paroxysms; and the patient usually lies on the back with the knees 
drawn up. The bowels are usually constipated, but sometimes the 
reverse; and commonly there are present nausea, vomiting, and 
hiccough. 

Treatment. — Apply hot fomentations and at once send for a 
physician. 

FISTULA. 

This is a troublesome ulcer near the anus, which communicates 
with the rectum. 

Causes. — Persons who follow sedentary occupations are more 
liable to them. 

Treatment. — Sometimes a cure will be effected by attending to the 
general health, and the injection of some astringent lotion, as solution 
of sulphate of zinc (forty grains to one pint of water). If this fails, 
it will be necessary to make a complete division with the knife of the 
whole of the parts between the fistula and the bowel, and the edges 
of the wound kept apart by lint, in order to allow the cavity to fill 
up by granulation. 

OBSTRUCTION OF THE BOWEL. 

An impediment, either mechanical or paralytic, against the passage 
of matter through the intestine. 

Causes. — Innervation of the bowel; malformation; telescoping of 
one portion of the bowel into the other; the growth of bands or mem- 
branes; the passing of the bowel through other openings, as in hernia 
or rupture; twisting of the bowel upon itself so as to obstruct the 
passage; the presence of foreign bodies in the bowel. 



384 DISEASES OF ADULTS. 

Symptoms. — Sudden and violent pain; vomiting; passing of bloody 
mucus when the form of telescoping is present and the obstruction is 
only partial; straining; complete constipation; vomiting sometimes of 
a sort of faecal matter ; rapid pulse ; and high temperature. 

Prognosis. — The general prognosis is not very good. The liability 
to sloughing of the parts, or of perforation, is very great. Operation 
with proper antiseptic observance gives much better results than 
formerly and the ratio of fatality is constantly decreasing. Where the 
cause is simple paralysis of the bowel there may be nothing more than 
a twisting of the bowel, which may suddenly right itself. 

Treatment. — The treatment is invariably surgical. 



APPENDICITIS OR INFLAMMATION OF THE APPENDIX. 

Inflammation of the vermiform (worm-shaped) appendix, an open- 
ing into the caecum (the enlarged commencement of the large intestine). 
The vermiform appendix is about one third of an inch in diameter and 
from one to six inches long. It does not lead anywhere and its use is 
obscure. 

Causes. — About 85 per cent, of the cases are due to the presence 
of micro-organisms lodged in the appendix under favorable conditions 
of growth. The majority of the rest of the cases are due to the 
presence of faecal matter and a few of them to the presence of foreign 
bodies, such as stones of small fruits, etc. As this is a blind passage 
without means of drainage very favorable conditions for the growth of 
micro-organisms may easily be set up in it. While the disease attacks 
all ages it occurs most frequently between the fifteenth and the thirtieth 
years. It attacks six times as many men as women, probably by reason 
of the greater frequency of catarrhal inflammatory diseases among men. 
It is least common among the poorer classes. The inflammation passes 
through the several stages of simple inflammation, ulceration, gangrene, 
and perforation. The greatest fatality attends the gangrenous type, 
from which sudden death often results without much preliminary 
disease. The greatest pain is felt from the formation and imprison- 
ment of pus in the appendix. 

Symptoms. — The symptoms vary not only in kind but in degree; 
so that it cannot be said that any one line of symptoms will be present 
in all cases. There is always pain in the abdomen, but it is often so 
distributed that the patient is unable to locate it with precision. This 



APPENDICITIS. 385 

pain varies from sharp, to agonizing, but its attack is usually sudden. A 
valuable indication of the disease is the rigidity of the muscle on the 
right side running from the pubic bone up to the ribs. Sometimes 
there is vomiting, slight fever, and quick pulse. After some days there 
may be a swelling on the right side of the abdomen due to the forma- 
tion of pus. 

Prognosis. — This varies with the type of the disease. Simple 
inflammatory cases will probably all recover. Gangrenous cases will 
probably all die. The latter demand prompt surgical care, in which 
case a majority may recover. 

Treatment. — Rest in bed; application of ice over the appendix. 
The intestines are not allowed to do any work that can be avoided. 
No food or drink is to be taken; no purgatives are used; and no 
muscular exertion is to be permitted. This is intended to reduce or 
to control the inflammation and is maintained for thirty-six hours. 
If at the end of that time there is not a marked improvement, an opera- 
tion is necessary. In such cases the operation is usually performed 
without an hour's delay. But when there is an improvement, the 
prevailing practice is to postpone the operation until after there has 
been a recurrence of the attack; then to operate in an interval. But 
of course all of that is a matter for the surgeon to decide. 



DISEASES OF THE LIVER AND SPLEEN. 
JAUNDICE OR ICTERUS. 

Catarrhal inflammation of the mucous membranes of the bile-ducts 
by which the flow of bile is obstructed. 

Causes. — Inflammation excited by excesses of eating and drinking; 
exposure; congestion of the liver; pneumonia; malaria; and fevers. 

Symptoms. — Pain in the stomach; foul tongue; loss of appetite; 
nausea and vomiting; slight diarrhoea; and fever. After from three to 
five days the whites of the eyes become yellow; the whole body gradu- 
ally assumes a yellowish tinge; the fever disappears; the skin is dry 
and itches; the bowels constipated; stools clayish or whitish in color; 
wind in the bowels ; much colic ; urine scanty and dark-colored from the 
presence of bile products. 

Prognosis. — The disease usually runs two or three weeks and the 
termination is favorable. 



386 DISEASES OF ADULTS. 

Treatment.— The patient should rest in bed; avoid exposure; and 
eat ripe fruits, vegetables, milk and limewater, broths, lean meat, eggs. 
No starch, sweet food, or fats should be given. 

The bowels must be kept open by: — 

Calomel, . y 4 grain. 

Bicarbonate of Soda, 3 grains. 

Take one such powder every two hours until twelve have been 
taken; then follow with a dose of Hunyadi Janos water. 

Or:— 

Bicarbonate of Soda, 4 drams. 

Tincture of Nux Vomica, 2 drams. 

Tincture of Capsicum, 1 dram. 

Tincture of Rhubarb, . . 2 ounces. 

Compound Infusion of Gentian, ... to make 6 ounces. 

Take a dessert-spoonful in water every three or four hours. 

The itching of the skin may be relieved by sponging with a weak 
solution of carbolic acid ; or by a hot bath in which a little carbonate of 
potassium has been dissolved. This bath may be given night and 
morning. 

Eclectic Treatment for Jaundice. 

As the stomach is usually disordered, it is well to give an emetic, 
and after it has acted freely administer a gentle purge. Should there 
be coldness about the feet or body, use the hot bath, or bathe the whole 
body with hot vinegar and water. A decoction made of dandelion and 
barberry root may be drunk freely. If these do not give immediate 
relief, take the following: — 

Golden Seal and Capsicum, of each, 1 dram. 

Bitter Root and White Poplar Bark, of each, 2 drams. 
Cover with boiling water. When cool, add half a 
pint of Holland Gin. 

Dose, a wineglassful three times a day. 

A strong tea of peach tree leaves, about half a pint taken daily; 
or from ten to forty drops of the tincture of bloodroot, taken three 
times a day, either in water or herb tea, have been highly recommended. 

GALLSTONES. 

Gallstones are concretions, sometimes formed in the gall bladder; 
they vary greatly in size, some being smaller than a pea, and some 
as large as a walnut; they often remain in the gall bladder without 



GALLSTONES. 387 

causing any uneasiness; but, when one of any considerable size passes 
into the duct, it gives rise to violent spasmodic pains which cease only 
when the stone has effected its passage into the bowels. The gall duct 
is, in caliber, no larger than an ordinary goose quill, and therefore this 
operation is often a difficult and protracted one;, its symptoms are 
agonizing pain in the region of the bladder, often accompanied by 
shivering and vomiting; when the obstruction has passed into the com- 
mon duct, and so stopped the flow of bile from the liver, there will be 
jaundice, with white and chalky stools. When there are these symp- 
toms, with absence of pain on pressure, and no fever, we may safely 
conclude that inflammation is not the exciting cause, but gallstones. 

Treatment. — The proper treatment in an attack of this kind is hot 
applications over the seat of pain. The pain should be relieved by 
anodynes or the hypodermic injection of morphia. Such treatment, 
however, is safe only in the hands of a competent physician. There is 
commonly great acidity of the stomach while gallstones are passing; 
hence an alkaline draught is of service, say half a teaspoonful of bi- 
carbonate of soda in a good quantity of warm water. Should the 
stomach reject these remedies, an anodyne may be administered in a 
clyster (forty drops of laudanum, in a pint of thin gruel). Hot bran 
poultices, sprinkled with laudanum, may be applied to the seat of pain. 

During the passage of gallstones much relief may be obtained by 
the use of ether, one dram to a pint of olive oil, one half of this amount 
to be taken during the seizure and repeated in twelve hours. 

When the foregoing lines of treatment fail there is danger that 
the calculus or stone may perforate the gall bladder or the walls of 
the biliary passages and surgical intervention should be sought. 



CONGESTION OF THE LIVER. 

In this condition the arteries or veins are over-distended with 
blood, causing slight jaundice, melancholia, and digestive disturbances. 
When the veins are congested- the cause is due to disease of the heart 
and lungs. When the arteries are congested the condition may be due 
to alcoholism, irregular dietary, constipation, or atmospheric changes. 

Symptoms. — Headache, feverishness, a furred tongue, loss of 
appetite, nausea, sometimes vomiting, constipation, and the urine is 
suppressed and highly colored. The skin becomes gray, sallow, or 
muddy in color. The white of the eye is tinged with yellow. There 



3 88 DISEASES OF ADULTS. 

is sense of weight in the region of the liver and weariness in the lower 
extremities. 

Treatment. — When associated with disturbances of digestion, 
wash out the stomach by drinking copiously of lukewarm water and 
irritating the throat to cause the water to be returned. Then give a 
dose of castor oil, or calomel one-fourth grain and bicarbonate of soda 
one grain every half hour for six or eight doses ; follow this with a dose 
of salts (Epsom or Rochelle), or a dose of Hunyadi water. 

A light nutritious diet together with bitter tonics, such as nux 
vomica ten drops, dilute nitro-hydrochloric acid ten drops, in half a 
glass of water fifteen minutes before each meal, constitutes the subse- 
quent treatment. When due to disease of the heart and lungs, the 
treatment will be directed to these organs and a competent physician 
consulted. 

GIN-DRINKER'S LIVER. 

This condition is due to diseases of the heart and lungs, syphilis, 
and chronic alcoholism. 

There are two types — that in which the liver contracts and that 
in which the liver is enlarged. 

Symptoms. — Those of a chronic catarrhal condition of the stomach 
and bowels associated with a slight jaundice, the urine being scanty 
and high colored and on standing throwing down a heavy deposit. 
There is abdominal dropsy, more or less pain over the region of the 
liver, nausea, and vomiting. The vomited matter contains blood, 
and the stools are sometimes tarry owing to the presence of blood. 
The patient becomes emaciated and greatly debilitated. Death usually 
follows within a year after the appearance of abdominal dropsy. 

Treatment. — Consult a physician at once. 

CANCER OF THE LIVER. 

This condition affects men most frequently. It is rarely found in 
women and children. The disease makes its appearance usually after 
the fortieth year. 

Causes. — Heredity, and possibly a cancer germ; this latter point 
is not yet settled. 

Symptoms. — General ill health, loss of appetite, nausea, vomiting, 
jaundice, constipation, loss of strength and weight. There is usually 



INFLAMMATION OF THE SPLEEN. 389 

some tenderness and pain, increased by pressure over the region of the 
liver. Sometimes a distinct tumor mass may be felt in the vicinity. 
Fever is not common and when present is only moderate. Towards 
the termination of the disease the additional symptoms are headache 
and delirium. 

Treatment. — Treatment is unsatisfactory. The condition terminates 
in death, but medical aid should be sought for relief of the early 
symptoms and later will be required for relief of pain. 

INFLAMMATION OF THE SPLEEN. 

This is often the result of chills and fever, and is very difficult 
and stubborn to cure. 

Symptoms. — A feeling of tightness and pain in the left side — the 
pain being increased on pressure, or by lying upon the left side. Some- 
times the organ enlarges, so as to be felt by the hand. There is some- 
times numbness, weakness of the legs, palpitation of the heart, difficulty 
of breathing, inability to exercise much, obstinate constipation, vomiting 
of food, piles, dry skin, tongue coated white or red, low spirits, and 
occasionally dropsical affections. 

Treatment. — Treatment should be about the same as in inflam- 
mation of the liver. After the active inflammation is subdued, the 
warm bath may be used once or twice a week. In the chronic form 
of the disease, counter-irritation with the compound tar plaster, with 
mustard poultices, or tincture of iodine, will be particularly needed. 
Keep the bowels open, and, if the patient is pale and bloodless, give 
iron combined with quinine and arsenic as a tonic. The following may 
be used : — 

Dried Sulphate of Iron, 30 grains. 

Quinine, 1 dram. 

Arsenious Acid, 1 grain. 

Mix and divide into thirty pills. Take one three times a day. 



DISEASES OF THE KIDNEYS. 
DIABETES INSIPIDUS OR EXCESSIVE FLOW OF URINE. 

This condition is more frequently met with in men than women. 
It occurs in early adult life. 



39Q DISEASES OF ADULTS. 

Causes. — It may be hereditary, or it may be due to certain diseases 
of the nervous system ; diseases of the brain ; spotted fever ; and injuries 
to the head. 

Symptoms. — The affection is characterized by great thirst, and 
enormously increased flow of urine, which is pale or very light straw 
color. The amount passed in twenty-four hours may be from one to 
six gallons. The urine is slightly acid, contains neither albumen nor 
sugar. The general health of the patient is usually good, but the 
appetite is voracious. 

Treatment. — If syphilis is a causative factor mercury and the 
iodide of potash will prove of benefit. When due to nervous irrita- 
bility, use the following: — 

Valerianate of Ammonia, 40 grains. 

Sodium Bromide, 2 drams. 

Compound Spirits of Lavender, 1 ounce. 

Simple Elixir, to make 2 ounces. 

Mix. Give one teaspoonful three times daily in a wineglass of 
water. 

Constipation should be relieved by the use of one compound vege- 
table cathartic pill at bedtime. (See "Constipation," page 370.) 



DIABETES MELLITUS OR SUGAR DIABETES. 

Symptoms. — This condition, met with in middle life and more fre- 
quently affecting men, is evidenced by an increased flow of urine — as 
much as seven or eight gallons may be voided in twenty-four hours. 
The color of the urine is pale, the odor sweetish, and sugar is constantly 
present. There is excessive thirst and appetite. The bowels are 
constipated, the skin is harsh and dry. The breath has a sweetish odor. 
The loss of weight and strength is progressive. The temper is irritable 
and the external genital organs itch intensely. The circulation in the 
extremities is sluggish. Disturbances of digestion, melancholia, and 
diseases of the heart, lungs, liver, and kidneys frequently appear during 
the course of the disease. Gangrene of the extremities is another 
complication met with. The diabetic patient is usually impotent. 

Treatment. — Consult a physician. The condition can be greatly 
ameliorated and some cases cured by careful dieting and judicious 
treatment. 



BRIGHT'S DISEASE. 391 

CONGESTION OF THE KIDNEYS OR RENAL CONGESTION. 

This is an acute catarrhal inflammation of the kidneys. Two 
varieties are known, termed active or arterial congestion, and passive 
or venous congestion. 

Causes. — The active variety is due to exposure to cold, injuries 
to the kidney region, extensive superficial burns, certain fevers, and the 
elimination in the urine of irritant substances, such as cantharides, 
copaiba, cubebs, turpentine, chlorate of potash, carbolic acid, etc. 

The passive variety is due to clotting of blood in the renal (kidney) 
vessels or diseases of heart or lungs. 

Symptoms. — Pain over the kidneys and running diagonally down to 
the pelvis and testicles, irritation of the bladder with constant or 
pressing desire to urinate, the urine being scanty, high colored, and 
containing some blood and albumen. There is headache, nausea, and 
sometimes vomiting. 

In the passive variety, when due to diseases of the heart or lungs, 
the urine is scanty, high colored, and contains albumen; dropsy soon 
appears. 

Treatment. — If the condition is not promptly treated serious 
damage to the kidney structure and chronic Bright's disease may 
develop. Therefore one should not attempt self-treatment but should 
consult a qualified physician. 

ACUTE BRIGHT'S DISEASE. 

Causes. — This disease may follow congestion of the kidney or be 
associated with infectious fevers such as scarlatina, diphtheria, typhoid, 
etc. "It is frequently met with in the course of pregnancy or may be 
due to the elimination of certain irritants such as cantharides, copaiba, 
turpentine, carbolic acid, arsenic, etc.; exposure to cold; injuries to 
the back. 

Symptoms. — It is a disease occurring in early life; at any rate it is 
more common in young than in old life. Dropsy is an early symptom, 
appearing first in the face with puffiness of the lower eyelids and later 
extends to the lower extremities and then to the abdomen. The 
onset, when sudden, is characterized by chill, fever, nausea, and per- 
sistent vomiting, aching pains in the small of the back, diarrhoea, 
irritation of the bladder and a desire to pass water frequently. The 
urine being bloody, presents an appearance like beef washings. There 



392 DISEASES OF ADULTS. 

is decided anaemia and general weakness. The condition lasts from 
ten days to three or four weeks. Affections of the heart, lungs, pleura, 
and peritonitis may develop as complications. 

Treatment. — Call a physician at once. Put the patient in bed, 
administer plenty of water and a strict milk diet. The outlook is 
favorable if promptly treated, but as uraemic poisoning may develop, 
self-treatment should not be risked. 



CHRONIC BRIGHT'S DISEASE. 

There are two distinct types of chronic Bright's disease : one in 
which the connective tissue of the organ is stimulated to overgrowth 
resulting in a large white kidney; the other in which the kidney sub- 
stance contracts and is called a small, red, granular, gouty, or 
contracted kidney. 

Large White Kidney: This sometimes follows acute Bright's, or 
may be due to chronic malarial poisoning, chronic alcoholism, chronic 
mercury poisoning, syphilis, etc., and is a disease occurring usually 
before the fortieth year. 

Symptoms. — In the beginning the symptoms may not be well 
defined. Later there will appear pufrmess of the lower eyelids and 
face, marked anaemia, emaciation, and general weakness. The quantity 
of urine in the beginning is decreased but frequently voided. Later 
in the disease, when the kidney substance contracts and we have to deal 
with a contracted white kidney, the urine changes from a high colored 
fluid to a thin watery liquid and is increased in amount. Albumen 
is constantly present in the urine of this type of Bright's. 

Dropsy eventually becomes general, and when the pleural sacs or 
cavities are involved, breathing becomes very difficult from compression 
of the lungs by fluid. A dropsical laryngitis may develop and the 
voice become husky. 

Treatment. — Rest in bed and a milk diet are of prime importance. 
The dropsy is relieved by purgation and sweating. A splendid diuretic 
to increase output of urine, lessen the amount of albumen and overcome 
general weakness is the following: — 

Strychnia Sulphate, 54 grain. 

Tincture of Chloride of Iron, 5 drams. 

Solution of Ammonium Acetate, 2 T / 2 ounces. 

Sweet Spirits of Niter, iy 2 ounces. 

Water, to make 6 ounces. 



UREMIA. 393 

Mix and take one teaspoonful every four hours followed by a glass 
of cold water. 

If the condition is due to syphilis, anti-syphilitic treatment will be 
required. A course of quinine in addition to the above diuretic will 
benefit cases due to chronic malaria. 

Prognosis. — As the condition is serious and unless carefully treated 
leads to a fatal ending, one afflicted with this disease should place him- 
self under the continued care of a competent physician. 

Small, Red, Granular, or Contracted Kidney : This is a disease of 
middle life and old age and is rarely met with earlier than the fortieth 
year. It affects men more commonly than women. 

Causes. — Somewhat similar to those of Large White Kidney; 
gout, alcoholism, mercury or lead poisoning, syphilis, worry, and the 
excessive consumption of red meats. 

Symptoms. — The disease is frequently well established before it 
is recognized. There is great thirst, also disorders of digestion, with 
loss of weight, and impaired hearing and vision. The skin is of a dead 
white, pasty color, is harsh, dry, scaly, and itches intensely. Nosebleed 
and cerebral hemorrhage are common. Nausea and vomiting occa- 
sional. The patient is drowsy. Convulsions, epilepsy, or apoplexy 
may develop. Dropsy, save of the white of the eye (the Bright's 
eye), seldom appears. Because of changes in the heart and blood 
vessels, there is shortness of breath on slight exertion. The urine 
is increased and of a pale and colorless appearance; there is rarely any 
sediment. Albumen is occasionally present. 

Treatment. — Rest and selected diet. Avoidance of alcoholic 
beverages. As uremic poisoning is very common and very severe in 
this type of Bright's disease, the patient should not attempt self-treat- 
ment, but abide by the advice of a qualified physician. 

URAEMIA. 

Causes. — By this term is meant certain manifestations of disturb- 
ances of the higher nerve centers, due to poisons, or waste products 
circulating in the blood, which poisons, or waste products, the kidneys 
fail to eliminate, as in Bright's disease and other affections of the 
kidney; in the course of pregnancy; and after operations on the rectum, 
uterus, bladder, etc. 

Symptoms. — It may develop gradually, or suddenly with convul- 
sions followed by stupor, or coma. There is suppression or decrease 



394 DISEASES OF ADULTS. 

of urine and more or less general dropsy. Usually the condition begins 
with a chill, or chilliness, dizziness, headache, and disturbances of 
vision and hearing. Gastro-intestinal symptoms may predominate — 
nausea, vomiting, rapid breathing, fever, and increased pulse rate, the 
vessels being full and tense. These symptoms may be followed by 
convulsions and death, or the patient passes into a profound sleep 
and dies. 

Convulsive seizures may predominate; these are epileptic-like, and 
there may or may not be loss of consciousness. There is high fever, 
rapid pulse, and short hurried breathing. The patient may pass into 
a profound sleep, the subject being overcome by the poison in the 
blood — death ends the scene ; or he may, after deep sleep of several hours, 
awaken and make a good recovery. 

Another manifestation of uraemia is that which comes on slowly 
with drowsiness, headache, and general irritability, and associated 
gastro-intestinal disorders, high fever, rapid pulse and respiration, 
or suddenly the patient is struck down as in apoplexy. The breathing 
sound is of a hissing character, the fever is high, the pulse flabby and 
weak but rapid, and consciousness is never regained. Or after sleep, 
more or less profound, the patient slowly recovers. 

Treatment. — Send immediately for a physician. Put the patient 
to bed. Remove the clothing. Apply artificial heat by means of hot 
water bottles (being careful not to burn the patient), or bathe with hot 
water and alcohol. Inject two or four tablespoonfuls of Epsom salts 
in four or five ounces of warm water into the rectum to promote elimi- 
nation through the bowels, and to stimulate the flow of urine. Apply 
hot cloths, wet with the infusion of foxglove (digitalis) over the 
bladder. 

Morphia sulphate, one fourth grain by hypodermic injection and 
repeated in two hours if needed, is most efficient in controlling convul- 
sions. Subsequently after an acute attack of uraemia, Keasbey and 
Mattison's Alkalithia, a teaspoonful in a glass of water (not too cold) 
one half an hour before meals, is of much benefit as a stimulating 
diuretic. 

SUPPRESSION OF URINE. 

If there is a frequent desire to pass water, attended with much 
difficulty, it is called Strangury. If none is made it is called suppres- 
sion of urine. 



INCONTINENCY. 395 

Causes. — Inflammation of the urethra; a lodgment of hard, faecal 
matter in the rectum, spasm at the neck of the bladder, exposure to cold, 
intemperance, stone in the kidneys or bladder, and enlargement of the 
prostate glands. 

Symptoms. — A constant desire, or feeling of necessity, to pass 
water, with pain and difficulty in passing it; and much enlargement 
of the bladder. If stone in the kidney be the cause, there is often 
nausea, vomiting, and acute pain in the loins; if stone in the bladder, 
the stream of water will be divided into two or suddenly checked. 

Treatment. — If much inflammation and irritation exist, all strain- 
ing to expel the urine should be avoided, and a catheter should be 
introduced every six hours, to draw it. The following will be found 
very useful remedies : Anodyne diuretic draught : — 

Mucilage of Gum Acacia, 6 ounces. 

Olive Oil iy 2 ounces. 

Mix well in a marble mortar, then add : — 

Sweet Spirits of Niter, 6 drams. 

Laudanum, 1 y 2 drams. 

Fennel Water, 3 ounces. 

Mix and take three tablespoonfuls every three hours. 
Or this : Demulcent diuretic draught : — 

Acetate of Potash, 2 drams. 

Laudanum, 1 y 2 drams. 

Syrup of Marshmallows, iy 2 ounces. 

Fennel Water, . . 8 ounces. 

Mix. Take three tablespoonfuls every three hours. 
The bowels may be kept free by using the following emollient 
clyster : — 

Balsam of Copaiba, 2 drams. 

The yolk of an egg. 

Rub this and the balsam together ; then add : — 

Castor Oil, y 2 ounce. 

Laudanum, 1 dram. 

Compound Decoction of Marshmallows, ..11 ounces. 

Mix. Inject up the rectum; this soothes the parts. 

INCONTINENCY OF URINE. 

This is rather a more troublesome than dangerous complaint, and 
young children and aged persons are most liable thereto. 



396 DISEASES OF ADULTS. 

Causes. — Most generally from a relaxation of the sphincter muscle 
of the bladder, from weakness, but sometimes it is caused by some irri- 
tating substance in the bladder, as a too acid condition of the urine or 
an inflammation of the mucous layer of the bladder; in children, it may 
arise from sleeping on the back, or from worms or eating too heartily 
at night. 

Treatment. — For children : — 

Citrate of Potash, I dram. 

Sweet Spirits of Niter, 6 drams. 

Camphor Water, to make 2 ounces. 

Mix. Two teaspoonfuls in a wineglass of water every three hours. 
Not to be given after four p. M. 
For adults : — 

Tincture Iron Chloride, 3 drams. 

Tincture Nux Vomica, 2 drams. 

Tincture Cantharides, 2 drams. 

Fluid Extract of Belladonna, 1 dram. 

Water, to make 3 ounces. 

Mix. Take a teaspoonful three times daily after meals. 

GRAVEL OR RENAL CALCULI. 

The condition of "stone in the kidney" due to the formation of 
accumulations of solid matter derived from the urine. 

Causes. — The conditions which are the fundamental cause of this 
formation are not at present quite clear. The fact that there is a 
quantity of solid matter in the urine is not the cause; for solid matter 
is present in all urine. There is a sticky, albuminous substance present 
which binds the solid matter together, and there is also some influence 
which causes it to form crystals. The stones are of all sizes from that 
of sand, which takes the common name of gravel and is often passed 
out through the urethra with the urine; up to a size of two or three 
inches in circumference, so that these cannot pass out through the 
natural channels. They vary also in color according to the nature of 
the solid matter of which they are composed. Those of uric acid and 
the urates are red and smooth; those of the phosphates, white and 
rough. Stones often show layers of different colors when cracked open, 
which is the result of deposits of different matter at different times. 

Symptoms. — Stones may be present in the kidneys for years without 
any indications of their presence. Sometimes the first sign is the 



GRAVEL. 397 

passage in the urine as gravel. But when the stone escapes into the 
ureter, it sets up that chain of symptoms known as renal colic. The 
pain in this case often becomes excruciating agony. It is caused by the 
stoppage of the passage by the stone; by the pressure of the urine 
upon the stone, which often causes a tearing of the membranes; and by 
the natural contraction of the ureter on account of the presence of the 
stone in it. The pain of renal colic does not confine itself to the 
immediate vicinity of the kidney and parts most affected; but radiates 
so as to extend into more remote parts. The paroxysms of pain may 
last for a few minutes or for hours. They often terminate suddenly 
on the escape of the stone into the bladder. Presence of blood in the 
urine on testing is a symptom of great value. This is from the 
laceration of the parts caused by the passage or lodgment of the stone. 

Prognosis. — The condition is serious and, while not an essentially 
fatal disease in many cases, there is always fear lest the patient die 
during the lodgment of the stone. The danger of recurrence is also 
great. 

Treatment. — This is directed first of all to the relief of the patient 
from the horrible agony of the "colic." A hypodermic injection of 
morphine, or of atropine, is often needed. Inhalations of chloroform 
are often given when the heart can stand it. If the patient is quiet 
enough hot applications over the kidneys are helpful. In the intervals 
the patient must drink copiously of a good water; if the urine is 
alkaline, he must take a lithia water. 

The following will render the urine acid : — 

Urotropine, 5 to jy 2 grains. 

Take one such dose every three hours. 
Or:— 

Ammonium Benzoate, 20 grains. 

Take one such dose in water every three hours. 

If the urine is acid, large quantities of water should be drunk 
daily and : — 

Bicarbonate of Potassium, 1 5 to 20 grains. 

Take one such dose three or four times a day. 

The diet must be carefully attended to; and any evidence of the 
presence of intestinal indigestion must be acted upon at once. Sweet 
wines and beer are not to be taken; no alcohol of any kind is the better 
rule. 

As exercise carries off the excess of uric acid, it is well for the 



398 DISEASES OF ADULTS. 

patient, more especially if he lead a sedentary life, to carry healthful 
exercise almost to the point of fatigue. At the same time he must 
drink copiously of water suited to his needs. Large draughts of water 
are necessary to keep the urine at the proper point of dilution. This 
is an effective way of carrying off the solid constituents of the urine, 
by which the formation of the stones is carried on. 

Serious and complicated cases of this disease require the attention 
of a surgeon. 

INFLAMMATION OF THE BLADDER OR CYSTITIS. 

Inflammation of the mucous membrane lining the bladder. 

Causes. — Retention of the urine and consequent distention of the 
bladder; foreign substances such as large stone in the bladder; inflam- 
mation of the adjacent parts and organs; enlarged prostate gland; 
chronic Bright's disease; and stricture of the urethra. 

Symptoms. — The acute form of the disease is marked in its 
approach by chills; fever; loss of appetite; and sleeplessness. The 
urine is frequently passed but only drop by drop, and the effort is 
followed by severe straining efforts. Pain over the bladder and a 
burning sensation in the urethra follow. The urine is often of bad 
odor and cloudy. 

Prognosis. — This is governed by the cause. Ordinarily acute 
inflammation is of favorable termination. When chronic, it is incur- 
able after enlargement of the bladder ensues. 

Treatment. — A milk diet with careful avoidance of highly seasoned 
or stimulating liquids; rest in bed; and warm applications over the 
bladder. The bowels are to be kept open, for which purpose use : — 

Bitartrate of Potash, i dram. 

Tincture of Senna, i dram. 

Manna, y 2 ounce. 

Warm Water, iy 2 ounces. 

To be taken at one dose. 

If the urine is acid (for tests of urine, see Index) the urine must 
be well diluted by copious drinking of a good lithia water. 
If the urine is alkaline, it may be changed by use of : — 

Ammonium Benzoate, 20 grains. 

Take one such dose every three hours. 

Or:— 

Solution of Citrate of Potassium, 1 ounce. 



INFLAMMATION OF THE BLADDER. 399 

Take one such dose every three hours. 

The general condition excited by the disease is much improved by 
use of : — 

Tincture of Hyoscyamus, 6 drams. 

Paregoric, 6 drams. 

Bromide of Potassium, 8 scruples. 

Bicarbonate of Soda, 8 scruples. 

Solution of Potassium Citrate, .... to make 8 ounces. 

Take a teaspoonful in water every two hours. 

Chronic inflammation of the bladder is attended by dull pain and 
frequent, scanty flow of urine. The urine contains large quantities 
of pus ; upon standing, a sediment of the nature of the white of an egg 
forms; this sediment shows phosphates and pus globules under the 
microscope. 

Prognosis. — This is not favorable in chronic cystitis. 

Treatment. — The diet should be mild and the alkaline mineral water 
should be freely used. Eucalyptol, in from ten to fifteen drop doses 
every four hours, well diluted ; or from five to ten drops of santal oil in 
capsules after meals may be given internally. The bladder may very 
beneficially be irrigated with an antiseptic every day. For this purpose 
use, first, tepid water, about two ounces, for a few days, then every day 
either : — 

Salicylate of Soda, . . 1 dram. 

Water, 1 pint. 

On- 
Boric Acid, 1 dram. 

Water, 1 pint. 

Only two ounces of either of these to be used until the capacity of 
the bladder is determined. 



4 oo DISEASES OF ADULTS. 

INFECTIOUS DISEASES OF ADULTS 



DENGUE OR BREAKBONE FEVER. 

An acute, epidemic fever (pronounced dangay), often called dandy 
fever. 

Causes. — It is believed that a micro-organism causes dengue. It 
is a disease of warm climates, being restricted in America to the southern 
states. It breaks out in a locality with sudden violence and attacks all 
classes and ages; but it disappears in cold weather and is not met with 
in high altitudes. 

Symptoms. — The fe^er quickly rises to 105 ; intense headache; 
burning pains in the temples; pain in the back; swelling in the joints; 
stiffness; pain in the muscles; nausea; vomiting; constipation, and a 
scarlatina-like rash. This stage lasts for from a few hours to two or 
three days. The symptoms then subside and there is an interval of two 
or three days. The second attack of the spasm is equally sudden but 
far less severe: the patient is weak; the rash is intensely itching; it 
remains for two days, and the skin peels off. The disease lasts for about 
eight days. Relapses are very common. 

Prognosis. — The outcome is always favorable in cases of healthy 
adults; old age and a state of debility are serious conditions, and it is 
among such cases that the greatest number of deaths occur. 

Treatment. — Absolute rest in bed is required, and in mild cases this 
is often all the treatment that is needed. In severe cases, an antipyretic 
and sedative is given such as : — 

Potassium Citrate, 5 grains. 

Sweet Spirits of Niter, -. . 30 drops. 

Take one such dose in a dessert-spoonful of water three times a day. 
The headache is relieved by applications of ice to the head (see page 241 ). 
If the face is flushed and there is throbbing in the head a hot foot bath 
is advisable. (See page 257.) The pains in the body are relieved by a 
hot tub bath. If the fever is high and long continued, which is seldom 
the case, sponging with tepid water will reduce it. (See page 251.) The 
poisons of the fever are eliminated by the kidneys; to insure this, the 
patient should be encouraged to drink freely. 



ERYSIPELAS. 401 

ERYSIPELAS. 

An acute infectious disease marked by more or less fever and a pecul- 
iar inflammation of the skin. 

Causes. — The micro-organism Streptococcus erysipelatis. A state 
of weakness or of debility and abrasions of the skin are predisposing 
causes. It is not a strongly infectious disease; one attack predisposes 
to others. 

Symptoms. — Erysipelas comes on suddenly with a chill; nausea; 
vomiting ; sometimes convulsions ; general illness ; headache ; pains in 
the limbs, and a fever of about 105 ; pulse is correspondingly high; 
tongue, coated ; diarrhoea or constipation ; urine, high-colored and scanty ; 
delirium is often present. An eruption of red spots appears, and soon 
they run together to form a violet or crimson patch on the skin, gen- 
erally on the face and neck. The patch is swollen, hot, and tender; the 
border is w T ell-marked and distinct. The affected parts burn, tingle, and 
itch; the surrounding parts are dropsical and puffy; this continues for 
five or six days ; then the skin of the affected part peels off and the fever 
declines. Sometimes the disease is inclined to creep to other parts; it 
is then called "traveling erysipelas." 

Prognosis. — Recovery is almost certain except in cases of those 
suffering from chronic alcoholism, and in the traveling form. 

Treatment. — In mild cases a laxative should first be given. This is 
followed by : — 

Tincture of the Chloride of Iron, 2 drams. 

Glycerine, 1 ounce. 

Water enough to make 2 ounces. 

Take one teaspoonful three times a day. Apply vaseline to the erup- 
tion. 

Or:— 

Ichthyol, 1 dram. 

Vaseline, 1 ounce. 

Use as an ointment to the affected part. 
In severe cases the patient should take : — 

Sulphate of Quinine, 2 grains. 

Extract of Belladonna, j4 grain. 

Tincture of Chloride of Iron, 10 to 20 drops. 

Take one such dose every three hours. 

The diet should be liquid, and it may be necessary to use alcoholic 
stimulants, preferably a good port wine. 



4Q2 DISEASES OF ADULTS. 

For local treatment the following produces excellent results: — 

Carbolic Acid, y 2 ounce. 

Oil of Turpentine, i ounce. 

Tincture of Iodine, i ounce. 

Alcohol, i ounce. 

Glycerine, y 2 ounce. 

Apply locally to the eruption. 
Or:— 

Sugar of Lead, I dram. 

Water, ' i pint. 

Laudanum, i dram. 

Pour a small quantity on a cloth and apply to the part. 

HYDROPHOBIA OR RABIES. 

An acute, infectious disease originating in the lower animals and 
communicated by them to man. 

Cause. — The cause is a peculiar virus contained in the nervous sys- 
tem, saliva, and urine of animals. This is conveyed to man usually by 
the breaking of the skin by a bite. It is believed that it is occasioned by 
a micro-organism, but that fact is not yet clearly established. The dis- 
ease shows itself in about 1 5 per cent of the number of cases of dog bite. 
It appears in from one week to two or more months from the time of 
the bite. If it does not appear within three months the chances are very 
great that the person will escape it. 

Symptoms. — The first stage lasts about twenty-four hours. The 
part begins to itch and burn, and the old scar may reopen. There are 
fear, anxiety, thirst, and the so-called fear of water, from which the 
disease takes its name. This symptom, on attempting to drink, is caused 
by the spasm of the pharynx, which is aggravated upon the thought of 
swallowing. This is the marked symptom of hydrophobia and serves to 
identify the disease. The stage of excitement follows, with difficulty 
in breathing and swallowing; there is marked sensitiveness to light and 
sound; fever to 103 ; often mania or delirium. This lasts for from one 
to three days. In the last stage the spasms subside; the heart fails; 
there is great prostration; and death follows from either convulsions or 
suffocation. This stage lasts for from six to eighteen hours. 

Prognosis. — In true hydrophobia, recovery is very rare after the 
disease is established. 

Treatment. — Immediate excision (cutting out) of the wound or 
burning with caustic or hot iron is imperative. If no other means are 
at hand the virus may be sucked out of the wound. This can be done 



HYDROPHOBIA. 403 

without fear of contagion provided there are no sores or scratches in 
and around the mouth for the poison to enter. The object in burning 
or cauterizing is to prevent the absorption of the poison into the system, 
either by removing the poison or by closing up the mouth of the absorb- 
ing vessels. The spasms may be controlled by a narcotic. The patient's 
strength is to be kept up by rectal feeding, as swallowing is impossible. 
(See page 236.) 

Symptoms of Hydrophobia in a Dog. — It is really of more impor- 
tance in diagnosing this disease to know the symptoms which appear in 
a dog than to know about those which appear in man. For if we can 
be quite sure that the dog does not show any signs of madness, we have 
the assurance that the person bitten will not be affected. The habit of 
shooting or otherwise killing a dog that has bitten one is wrong, at 
least until after an opportunity for a thorough study of his case has been 
afforded. Dr. Hare says that a dog is at first stupid and heavy and 
often cross and restless. When he stands up he is inclined to sway and 
stagger as he runs. He refuses food and water, though he may gulp 
down pieces of cloth, wood, etc. He may be obedient and not bite his 
master. He may bark at and bite strangers. His bark is hoarse and 
muffled, more of the nature of a series of yelps. The lower jaw never 
closes completely as in health. Then follow thirst and the inability to 
drink by reason of the contraction of the muscles of the throat, which 
are first attacked by the disease. Then comes the stage of excitement, in 
which he develops mania or delirium, running about as though in fear; 
mouth open; saliva flowing from it; and the dog seems to be blinded, 
for he runs into objects that he meets, snapping and biting. Emacia- 
tion comes on quickly. Paralysis follows ; convulsions ; and death on the 
sixth, eighth, or tenth day. 

It is not generally known that there is a form of the disease called 
the "dumb rabies," in which the dog does not bark or display any signs 
of mania or delirium. Dr. Gill, a veterinary surgeon of New York, 
has said that the dog has the appearance of having a bone in his mouth. 
He not only does not avoid water but often plunges into it and swims. 
Dr. Gill's advice on this point is : "Beware of a dog when he becomes 
dull and hides away, appears restless, is always on the move and prowl- 
ing, whose countenance is somber and sullen, and who walks with his 
head down like a bear. Beware of one who barks at nothing when all 
is still. Beware of the dog that barks incessantly and tears up things. 
Look out for the dog that has become too fond of you and is continually 
licking your hand and face ; and beware, above all, of the dog that has 



404 DISEASES OF ADULTS. 

difficulty in swallowing, who appears to have a bone in his throat, and 
of one who has wandered away from home and returns covered with 
dirt, exhausted and miserable." 

INFLUENZA OR LA GRIPPE. 

An acute, highly infectious, febrile disease, which affects large areas 
at the same time. 

Causes. — It is caused by the bacillus of Pfeiffer, which was first 
isolated and studied in 1892, when the disease came into prominence 
during the epidemic. It can be conveyed by contact and the usual infec- 
tious methods; the germs remain in the nasal passages for some time 
after an apparent recovery so that it is possible, for a person to reinfect 
himself. Atmospheric influences seem to be instrumental in the wide 
spread of the disease; and debilitating diseases which leave the patient's 
vital resistance lowered also are predisposing causes. 

Symptoms. — Ordinary cold in the head, coryza, and influenza have 
many symptoms in common during the early stages. There are severe 
chill; rapid rise of temperature to 105 ; general illness; congestion of 
the nasal passages ; difficulty in breathing ; general depression ; pain in the 
chest, back, and limbs ; serious heart difficulty, and prostration. 

Prognosis. — In young and healthy adults the termination is almost 
invariably favorable; but in the case of very young patients or very old 
persons, the disease is more serious. Complications also make the prog- 
nosis sometimes very grave. 

Treatment. — Rest in bed is the first essential. An eminent authority 
has said : "He who remains out of bed during an attack of la grippe 
takes his life in his hands." The diet must be semi-solid. (See page 
281.) The utmost care must be taken in disinfecting all the discharges 
from the body. As the nasal passages are often the seat of the bacillus, 
care must be taken to burn cloths used as handkerchiefs by the patient. 
(See page 152.) The bowels must be kept open by J4 grain doses of 
calomel every two hours. Hot foot baths and hot tub baths are beneficial 
in the early appearance of the disease. (See page 251.) The coal tar 
products have been used in enormous quantities in this disease, but they 
are to be avoided by reason of the heart's condition. The pain in the 
back, chest, and limbs may be relieved by : — 

Salicine, - 5 grains. 

Sulphate of Quinine, - 2 grains. 

One such dose to be taken in a capsule every five hours. Hot stupes 
are of great relief . (See page 234.) 



LOCKJAW. . 405 

The congested state of the nose and throat is relieved by : — 

Compound Tincture of Benzoin y 2 ounce. 

Boiling Water, 1 pint. 

Frequently inhale the vapor from this while very hot. 
Also : — 

Chloride of Ammonium, 10 grains. 

Tincture of Hyoscyamus, 15 drops. 

Syrup of Ipecac, 5 drops. 

Whisky, y 2 dram. 

Chloroform Water, i l / 2 drams. 

Take one such dose in water every three or four hours. 

Food must be nutritious and easily digestible during the attack in 
order to keep up the patient's strength. During convalescence good food 
and tonics must be supplied to ward off complications. 



LOCKJAW OR TETANUS, 

An acute, infectious disease marked by such rigidity of the muscles 
that the jaws are locked and the limbs are set. 

Cause. — It is communicated by the entrance of the Bacillus tetanus 
into the system through wounds or abrasions of the skin. It is found in 
soils of gardens about stables and manure piles. It is most prevalent in the 
United States in Louisiana, New York, Pennsylvania, Texas, and Ohio, 
in the order mentioned. The bacillus has been found on the object that 
causes the wound, although it may come from other contact. The prac- 
tice of going barefoot is predisposing. Most of the deaths have been 
Fourth of July celebration accidental deaths caused by wounds from the 
toy explosive pistols. 

Symptoms. — The symptoms are characteristic : the muscles become 
set and rigid; the lower jaw is immovable by reason of the spasm in the 
masseter muscles; the muscles of the face contract so as to give the 
appearance of a horrible laugh (risus sardonicus) , the body is arched by 
the contraction of the muscles in the back; temperature ranges from 
ioo° to 106 . 

Prognosis. — The deaths are higher in the acute than in the chronic 
form; in the latter only 50 per cent and in the former 80 per cent. In 
very severe cases death occurs on the second day, sometimes on the sixth. 

Treatment. — Tetanus antitoxin injection is the very first step in the 
treatment. The wound must be thoroughly washed after cauterizing or 
excision, if this latter is possible. The wash should be some antiseptic 



4o6 DISEASES OF ADULTS. 

wash not too strong. (See page 261.) The wound must not be closed 
during the early stages. It is of the utmost importance that bacilli, if 
present, be allowed to escape, or be thoroughly washed out. The safest 
way to treat wounds that may develop tetanus is to cause them to heal 
by granulation, not by first intention. 

As soon as the disease develops, it is important to look after the nour- 
ishment of the patient. If the attack is the acute variety this is not so 
necessary; but in the more chronic form it will be necessary to resort to 
the extraction of one or more teeth to admit the passage of the stomach 
feeding tube, or to pass it through the nose. Narcotics and sedatives 
are used to control the paroxysms. 



MALARIA, INTERMITTENT OR REMITTENT FEVER. 

An infectious, intermittent or remittent fever, marked by enlarge- 
ment of the spleen, anaemia, and chills. 

Causes. — It is due to a micro-organism, the Plasmodium malariae, 
which gains access to the body through the bite or sting of a mosquito 
belonging to the genus anopheles. Dangerous places in this respect are 
marshes and low, damp ground that harbor and breed mosquitoes. As 
the mosquito is of nocturnal habits, the disease is most generally con- 
tracted at night. 

Symptoms of the Intermittent Type of Malaria. — There are four 
stages of this form; cold, hot, sweating, and the interval when fever is 
absent. 

Cold Stage. — Severe chill ; fever ; thirst ; headache ; nausea and, some- 
times, vomiting; lasting not over an hour, when it is followed by the 

Hot Stage. — Pulse rapid; fever increases; skin red and hot; thirst; 
nausea and vomiting, and headache; all symptoms of fever greatly in- 
creased. These symptoms last for less than an hour, or sometimes per- 
sist for five or six hours. The fever suddenly subsides and and the 
patient passes into the 

Sweating Stage. — The sweat appears first on the forehead and then 
rapidly spreads over the entire body; headache ceases; the pulse drops 
to normal ; in from one to three hours the patient falls into a refreshing 
sleep and begins the 

Stage of Freedom from all signs of the disease. These attacks may 
occur daily, every other day, or may appear on two consecutive days 
and skip the third, or, again, may appear every fourth day. 



MALARIA. 40; 

Prognosis. — Recovery is the general rule, if the patient is treated. 
Without treatment there is danger of the disease becoming chronic or 
complicated. 

Treatment. — During the cold stage the patient may take hot drinks ; 
warm applications and one or two teaspoonfuls of Hoffman's Anodyne 
in water may be given. 

During the hot stage he may take cooling drinks such as : — 

Cream of Tartar. 1 ounce. 

Hot Water, 1 pint. 

Allow it to cool and use liberally as a drink. 
Allay the fever by alcohol sponging (page 253). 
During the sweating stage, sponge the body with warm water or 
with alum and hot water in these proportions : — 

Alum, 4 drams. 

Alcohol, 4 drams. 

Water, 1 pint. 

Apply with the hand or with a sponge. 

During the interval of freedom from symptoms give : — 

Calomel, 4 or 5 grains. 

Bicarbonate of Soda, 4 or 5 grains. 

Follow this dose in four or five hours with a saline aperient such as 
Hunyadi Janos water, Epsom or Glauber's salts. 

About four or five hours before the expected return of the attack, give 
a heavy dose of : — 

Sulphate of Quinine, 10 to 15 grains. 

Or a Clark Powder consisting of : — ■ 

Sulphate of Quinine. 10 grains. 

Capsicum, 2 to 4 grains. 

Powdered Opium, 1 grain. 

After the fever has been broken up and the paroxysms do not return 
give :— 

Fowler's Solution of Arsenic, 5 to 10 drops. 

in water every four hours for an extended period. 
Or:— 

Tincture of Chloride of Iron, 20 drops. 

Take in water every four hours. 
Or:— 

Dried Sulphate of Iron, 30 grains. 

Sulphate of Quinine 30 grains. 

Arsenious Acid, 1 grain. 

Extract of Gentian, 40 grains. 



408 DISEASES OF ADULTS. 

Divide into 30 capsules and take one after each meal. 
For preventive measures, see page 156. 

GLANDERS OR FARCY. 

This is a malignant disease occurring in the horse and mule and 
which man is liable to contract by inoculation or simple contact with the 
skin. It is a horrible and loathsome disease, and often proves fatal. 
An animal affected by it should at once be killed and the body buried. 

Symptoms. — The chief symptom of its presence in the animal is 
inflammation of the lining membrane of the nostrils, which becomes 
ulcerated, and emits a bloody, fetid, sticky, yellowish discharge. Shortly 
after a person contracts the disease there are febrile symptoms, probably 
vomiting and diarrhoea; small ulcerating tumors form under the skin hi 
various parts of the body, and the peculiar viscid discharge from the 
nostrils commences which is characteristic of the disease. Domestic 
treatment should not be attempted, but a competent physician employed 
without delay. 

SMALLPOX OR VARIOLA. 

An acute, epidemic, contagious disease affecting the entire body. 

Causes. — It is believed to be due to a parasite called Cytoryctes 
vaccinae, which is of great vitality and persistence. The disease is 
spread by clothing and the air. 

Symptoms. — The incubation period, that is, the time from exposure 
to the disease until it appears, is from ten to sixteen days. The attack 
is sudden. There is first a chill ; vomiting ; intense pains in the head and 
in the back, the latter running down the legs. The extreme severity of 
these pains is often enough to excite suspicions that the on-coming dis- 
ease is smallpox. The fever quickly runs up to 103 and 104 in the 
first few days. The pulse is rapid, from 100 to 130 beats per minute, 
but full and strong. The face is red and the eyes bloodshot. Coarse 
red spots appear during the third day upon the forehead and lips. This 
eruption is sometimes preceded by a rash very much resembling either 
that of scarlet fever or of measles. As soon as the true eruption appears 
the other symptoms abate. The eruption passes through several stages, 
from the hardness of shot to mature pustules filled with matter sur- 
rounded by a red band. On the tenth day, or a day or so later, the 
pustules begin to dry up and crust over. The odor is powerful and 
offensive as soon as the scabs or crusts have formed. These latter fall 



SMALLPOX. 



409 



off from the seventeenth to the twenty-fourth day, leaving the character- 
istic pit or scar known as "pockmark." 

When the pustules run together, the disease is known as Confluent 
Smallpox, and is a more dangerous form of the disease, as all of the 
symptoms are aggravated. 

When the pustules are blackened by blood in the form of hemorrhage, 
the disease is known as Malignant or Black Smallpox. Cases of this 
form are nearly always fatal. 

Those who have been vaccinated take the disease in a modified form, 
of shorter duration, and without fever. This is known as Varioloid. 

Prognosis. — In the ordinary form about four out of a hundred die; 
in the confluent form, fifty out of a hundred ; and in the black or malig- 
nant form, nearly all die. In the mild type of those who have not been 
vaccinated, the fatality is from twenty to sixty out of a hundred. Vac- 
cination exerts a positive protective influence against the disease, either 
preventing it altogether or changing it to varioloid. 

Treatment. — Isolation, disinfection, and full preventive measures 
to be taken as given on page 152. The patient is put to rest in bed in a 
darkened room, kept at a temperature of about 65 °. The diet must be 
light and easily digestible, consisting of milk, eggs, eggnog, soups, 
broths, oysters, beef juice, supplied every three hours. Headache is 
relieved by the ice cap or sinapisms to the head ("Nursing," page 241). 
The fever at the start may be allayed by 10 grain doses of phenacetine or 
antipyrine; or by from 5 to 10 grains of acetanilid, or 5 grain doses of 
antifebrine. 

Insomnia and delirium are treated by opium, chloral or trional. Fever 
is reduced by cold sponge baths (page 252). 

The mouth and nose should be syringed with Dobell's solution (page 
329). The eyes, which become inflamed, should be washed with a solu- 
tion of boric acid. The mouth should be washed with an antiseptic 
solution, both for cleanliness and comfort ("Nursing," page 241). 

Itching caused by the eruption may be allayed by the application of 
Carron Oil, which is equal parts of limewater and olive oil. Or the 
following ointment may be used: — 

Eucalyptol, 1 dram. 

Carbolized Vaseline, 1 ounce. 

Apply lightly to the pustules with a feather. Hot water dressings 
are also grateful. These washes and oils, in addition to allaying the 
itching, also in a measure prevent pitting. 

See * 'Vaccination." 



4 io DISEASES OF ADULTS. 

TYPHOID OR ENTERIC FEVER. 

An acute, infectious fever, in which the lower intestine, the spleen, 
and the mesenteric glands are chiefly iirvolved. 

Causes. — It is caused by infection from the bacillus typhosus of 
Eberth, the discoverer. This is taken into the body in food, such as 
drinking water, milk, ice, oysters, etc. The bacillus excites a catarrhal 
inflammation of the lining of the intestine, which later ulcerates and 
sometimes causes perforation of the bowel. The disease passes through 
a period of incubation which varies from one to three weeks. 

Symptoms. — The disease begins with a feeling of general illness 
and it is usually some days before any well-marked symptoms appear. 
Among the earliest are an aching in the forehead, pain in the back and 
limbs. There is a state of mental dullness, and sometimes a slight deaf- 
ness. At first the tongue is coated, but very soon the edges become clean 
and red, while the coating in the middle persists. During the first week 
the headache increases and is accompanied by sleeplessness and thirst. 
A mild degree of fever is noticeable, and there are often repeated attacks 
of nosebleed. The bowels are generally constipated during the first 
week, but sometimes diarrhoea sets in early, and the stools are the char- 
acteristic pea-soup stools of the disease. Meanwhile the temperature 
climbs up day by day, until, at the end of the first week, it is from 102 
to 104 , being higher at night than in the morning. The pulse gains as 
the fever rises, and at the end of the first week it is from 90 to 100 beats 
per minute. Between the seventh and the ninth day there appear' on the 
abdomen from five to thirty red spots which disappear on pressure. These 
come in crops and remain for from three to five days, when they are fol- 
lowed by another group. The tongue is dry and shows cracks on the 
surface. Diarrhoea is profuse, and at the end of the second week the 
fever has reached the crisis. If the attack is severe the patient is deliri- 
ous, marked by muttering, the teeth and lips are covered with crusts or 
coatings called sordes. During the third week the symptoms continue 
and become intensified. The skin is dry and harsh and the patient shows 
great emaciation. Improvement is looked for at any time between the 
fourteenth and twenty-eighth days, according to the severity of the attack. 
During convalescence the patient emerges from the attack thin, feeble 
and hungry. 

Prognosis. — While upon the whole this is favorable in the total num- 
ber of cases, it is hard to give an accurate prognosis in any particular 
case. So much depends upon whether the patient has gone to bed early 



TYPHOID FEVER. 411 

in the attack and conserved his energy to withstand it. The degree of 
absorption of poisonous matter during the course of the disease, and 
the chances of perforation of the bowel, are also large factors, to say 
nothing of the many complications which may arise. Among these latter 
are ulceration of the entire gastro-intestinal tract, or of parts of it, 
hemorrhage from the bowel, pneumonia, meningitis, and paralysis. A 
sudden drop in the temperature to normal is a grave symptom, and sug- 
gests perforation. Still coma, where the patient is apparently awake 
but takes no notice of his surroundings, is also serious. Then there is 
always the very great possibility of a relapse. 

Treatment — If the patient is put to bed early in the attack 
his chances are greatly improved. Rest, tranquillity of mind and body, 
mean much as a fortification against the long period of emaciating and 
enervating fever. That form of the disease popularly known as "walk- 
ing typhoid," while mild in the demonstration of symptoms, is very fre- 
quently the most pernicious by reason of the grave complications which 
so often cause a fatal termination of it. There is probably no other 
disease which demands and so well repays good nursing as does typhoid. 
Thorough nursing and exact and persistent preventive measures are half 
the battle. All of the preventive means as laid down on page 152 must 
be rigidly used. 

Half hour doses of one quarter grain of calomel should be given 
until one or two grains have been given or until the bowels move. This 
is followed by some such mild saline aperient as Hunyadi Janos water, 
Epsom or Glauber salts. Throughout the course of the disease give : — 

Dilute Hydrochloric Acid, 5 to 10 drops. 

Essence of Pepsin, 1 teaspoonful. 

Give one such dose every six hours after eating. 

The fever is to be reduced by the cold rub, cold sponge bath, cold 
pack, or Brand's cold plunge bath. Full directions for the administra- 
tion of these for reduction of fever are to be found on page 231. 

The diet is absolutely a liquid diet for the first and often for the 
greater part of the second week.. The patient takes from one to one and 
a half quarts of milk in the twenty-four hours in small quantities every 
two or three hours. If the stools show curds, too much milk is being 
given and it must then be diluted with limewater or Vichy. The milk 
may be peptonized to render it more easily digestible. (See page 288.) 
Towards the last of the second week the patient may take soft boiled eggs, 
little more than warmed through so that they may be drunk from a glass. 
Or the eggs may be beaten and strained. Mixed with milk they may 



4 i2 DISEASES OF ADULTS. 

be rendered more palatable by flavoring with vanilla, lemon juice, etc. 
Among the broths that may be given, chicken is, perhaps, the best. If 
there is a tendency to diarrhoea after the broth, it is probably due to 
the fat in it. To correct this, set the broth to cool, when the fat will 
rise and form on the top ; it may be skimmed off, and the broth warmed 
over. In constipation, the fat, of course, should be given with the broth. 
Gruels from rice, cornstarch, barley well-cooked may now be added to 
the list, but they may be a little difficult to digest. This may be overcome 
by the addition of a little taka-diastase to them. 

There is no objection to giving the patient small quantities of cool, 
but not iced, water when he craves it to allay thirst. The mouth is to 
be washed and swabbed frequently with listerine, glyco-thymoline, or 
boric acid solution. (See "Nursing," page 254.) If prostration be indi- 
cated by weakened heart action or slow pulse, whisky or brandy may be 
given in half-ounce doses every three hours in the milk to promote 
digestion. 

The use of the bath to reduce temperature is intended to take the 
place of antipyrine and the other fever agents, not to be taken along 
with them. The cold method is sufficient, and the drugs only increase 
the already great exhaustion. 

Diarrhoea is not to be checked unless the stools exceed more than 
three in the twenty-four hours. For this purpose give : — 

Subnitrate of Bismuth, 20 grains. 

Carbolic Acid, 1 drop. 

Paregoric, 15 drops. 

Tincture of Deodorized Opium, 8 drops. 

Mucilage of Acacia, 1 dram. 

Water, , 3 drams. 

Give one such dose every three or four hours. 

Constipation may be best treated by enemas. (See "Nursing," page 

254.) 

Accumulation of gas in the intestines and the abdomen, called tym- 
panites, is relieved by cold compresses, ice bag, or turpentine stupes 
to the abdomen. (See "Nursing," page 254.) 

Headache is treated with ice bag to the head, and if necessary : — 
Bromide of Soda, 10 grains. 

Take one such dose every two or three hours. 

Insomnia is often relieved by a glass of hot milk, or one ounce of 
whisky in water. 

Delirium is largely prevented or lessened by keeping up the strength. 



TYPHUS FEVER. 413 



TYPHUS FEVER. 

Typhus fever is a kind of contagious fever, characterized by the ordi- 
nary symptoms of other fevers, accompanied with debility in the nervous 
and vascular systems, and a tendency to putrefaction. 

Causes. — The cause of typhus is contagion, the activity of which is 
much increased by the crowding of human beings into close, ill-ventilated 
and filthy places with insufficient nutriment, and other causes which tend 
to depress the vital power. It is eminently contagious and infectious, 
and often prevails epidemically in jails, on shipboard, and in famine- 
stricken regions. 

Symptoms. — The symptoms are great prostration of strength, high 
fever, weak and irregular pulse, nausea, vomiting, flushed countenance, 
parched and furred tongue, and excessive thirst. In the worst cases 
black or purple spots appear on the skin ; there is a peculiar fetid smell, 
and sometimes there are discharges of blood. The duration of this fever 
is uncertain : sometimes it terminates between the seventh and fourteenth 
day, and sometimes it is prolonged five or six weeks. Its duration de- 
pends greatly upon the constitution of the patient, and the manner of 
treating the disease. The most favorable symptom is a warm sweat 
after the fourth or fifth day. This will continue some time and carry 
off the fever. Eruptions about the mouth and nose may be regarded as 
favorable. 

Prognosis. — The unfavorable symptoms are excessive looseness of 
the bowels, with a hard, swelled abdomen, black or livid blotches break- 
ing out on the skin, sore mouth, cold, clammy sweat, change of voice, 
inability to put out the tongue, a constant inclination to uncover the 
breast, difficulty of swallowing, sweat, and sputum tinged with blood, 
and the urine black, or depositing a black sediment ; such symptoms indi- 
cate death. 

Treatment. — In the early stages of this disease it is best not to inter- 
fere much with nature. The principal aim ought to be to keep up the 
patient's strength until the fever poison has expended itself. When seen 
early, however, it is often of advantage to administer an emetic; and 
the patient's uneasy sensations will be much soothed by sponging the 
surface of the body with cold or tepid water. When the powers of life 
begin to fail, a stimulating course of treatment should be commenced, — 
such as strong beef or chicken tea, with wine or brandy frequently admin- 
istered, taking care that it does not aggravate the febrile symptoms. 



4H DISEASES OF ADULTS. 

When there is much general irritability and sleeplessness, a dose of opium 
may be given. The patient should be in a large, well aired apartment, 
and the windows kept open as much as possible. As the patient begins 
to recover, a course of tonics will be necessary to expedite his restoration 
to health. The attendants usually contract this fever. 
For preventive and disinfecting means, see page 155. 

YELLOW FEVER. 

An acute, infectious fever occurring in three stages — the febrile, the 
interval or remission, and the collapse. It occurs most frequently in 
June, July, August, and September. The regions most affected are the 
tropics in certain well defined areas, from which it is never absent. 
Natives and negroes within those areas are, to a greater or less extent, 
immune, but strangers are very susceptible. Cases occur in other parts 
of the world, many of them being carried by ships. Seaport towns are 
most likely to have such cases. 

Cause. — It is communicated by a micro-organism, the Bacillus icter- 
oides, which is carried and transmitted in the bite of a mosquito, the 
Stegyomia fasciata. 

Symptoms. — It usually breaks out after from one to six days after 
exposure to the infection. The symptoms of the first or febrile stage are : 
general illness and weakness; headache; chill; high fever, running up 
to 104 or 106 ; pains in the back, head, and limbs; pulse is rapid; face 
flushed ; stomach nauseated ; eyes bright. One of the most marked pecul- 
iarities of the symptoms is the action of the pulse, which mounts up at 
first as the fever rises and then suddenly shows a tendency to fall. The 
urine is high-colored and scanty; the bowels are constipated; and the 
patient emits a peculiar odor from the body. This stage lasts for from 
one and one half to three or four days. 

The second stage, or the interval, is marked by a fall in the tempera- 
ture to about 99 or ioo°, with a general lessening in the severity of the 
symptoms. Recovery may take place at this stage. If not, it lasts for 
from a few hours to four days, when the third stage begins. 

The symptoms of the period of collapse are : a return of all the symp- 
toms with greater violence; jaundice; black or "coffee-ground" vomit; 
hemorrhages from the bowels and mucous membranes generally; w T eak 
pulse ; cold skin ; irregular breathing ; and death from exhaustion without 
loss of consciousness. 

Prognosis. — Fatality runs from 15 to 85 per cent. Unfavorable 
symptoms are black vomit, suppression of urine, high fever, and collapse. 



CHOLERA. 



415 



Treatment. — Rest in bed; mild laxatives such as castor oil, citrate 
of magnesia, and calomel in the early or first stage; in the early stages 
the diet must be confined to milk, sago, and arrowroot, and similar bland 
articles. As the disease advances, the strength should be kept up with 
broths made from lean meat, and thickened with bread crumbs, oatmeal 
or barley. Strict cleanliness must be observed about the patient and the 
bed linen. Good nursing is of great importance. If the stomach is 
very irritable and the vomiting excessive, give : — 

Powdered Rhubarb, 20 grains. 

Bicarbonate of Soda, 20 grains. 

Powdered Peppermint Leaves, 1 teaspoonful. 

Laudanum, 15 drops. 

Brandy, 1 tablespoonful. 

Boiling Water, 1 gill. 

Mix. Sweeten with loaf sugar and give a tablespoonful every hour. 
The patient should be supported by stimulants such as alcohol, strych- 
nine, etc. 

ASIATIC CHOLERA. 

The Asiatic, malignant, or pestilential cholera is a very violent form 
of disease. It commonly comes on without any warning in one whose 
previous health has been apparently sound. Or it may be preceded by 
acute diarrhoea, with nausea and vomiting. 

Causes. — An acute specific germ infection, the particular germ 
being the Comma bacillus. The cholera stools transmit the infection. 

Symptoms. — There are three stages : the first stage is the stage of 
invasion, in which there are symptoms of mild diarrhoea, colic, general 
weakness, some chilliness, headache, and sometimes nausea and vomit- 
ing. The second stage: the diarrhoea increases, the discharge is thin, 
colorless, and like rice water. Vomiting is more constant, there is great 
prostration, the skin is cold and clammy although the temperature may 
be quite high, the features are pinched, urine is scanty, the pulse almost 
imperceptible, the eyes sunken and surrounded by a dark circle; the 
patient sinks into a state of apathy, and, unless a favorable change 
speedily takes place, he soon expires. This stage may last from a few 
to forty-eight hours. 

Third stage or stage of reaction : when reaction does take place, 
the pulse gradually returns, the natural warmth of the body is restored, 
the urine is more copious, the vomiting stops, fever and diarrhoea 



416 DISEASES OF ADULTS. 

gradually subside. Frequently, however, the reaction is accompanied 
by fever of a typhoid type, which prolongs convalescence or terminates 
fatally in from four to eight days. 

Treatment. — Put the patient at rest in bed,, withhold food for a few 
hours, quench the thirst by allowing the patient to suck pellets of ice. 
Give large doses of calomel, three to five grains every two hours for 
three or four doses. Follow with a dose of castor oil, wash out the 
bowels with two or three gallons of hot water to which is added com- 
mon salt, one level teaspoonful to the quart. This should be done twice 
daily. 

For the diarrhoea nothing succeeds better than the following, accord- 
ing to the late Roberts Bartholow : — 

Deodorized Tincture of Opium, 3 drams. 

Aromatic Sulphuric Acid, 5 drams. 

Mix. Give ten to twenty-five drops every hour or two in one or two 
tablespoonfuls of water. 

Vomiting is best controlled by use of : — 

Carbolic Acid, 4 grains. 

Bismuth Subnitrate, 2 drams. 

Glycerine, 3 drams. 

Peppermint Water, to make 3 ounces. 

Mix. Give a tablespoonful every two hours until relieved. Hot 
applications over the bowels are also beneficial : the body heat should be 
kept up by means of hot water bottles externally and hot coffee by the 
rectum. Nutritious diet is required. 

The following has been very effectual in curing severe cases of 
virulent cholera : — 

Tincture of Opium, Tincture of Camphor, 

and Spirits of Turpentine, of each, .... 3 drams. 
Oil of Peppermint, 30 drops. 

Mix. Dose, one teaspoonful in brandy and water, for the mild 
form of cholera ; and one tablespoonful for the more virulent. 

As a preventive the following may be taken in cholera times : — 

Bicarbonate of Soda, 1 scruple. 

Ginger, 8 grains. 

Take in a glass of water, after breakfast and supper. 



GENERAL DISEASES OF ADULTS 



ANEURISM. 



A sac of blood formed by the expansion within defined limits of the 
coats of an artery. There are aneurism of the arch of the aorta, of the 
thoracic aorta, and of the abdominal aorta. 

Causes. — A weakening of the coats or walls of an artery; exertion; 
the break-up of the tissues in old age; alcoholism; syphilis; diabetes; 
malaria; gout; rheumatism; Bright's disease; exposure and excesses of 
various kinds. 

Symptoms. — An elastic, pulsating tumor may be felt in the region 
affected; auscultation reveals an aneurismal murmur; deep-seated pain 
in the thorax or part affected; paralysis from pressure on the nerves; 
difficulty in breathing and in speaking are often noted; pupils may be 
contracted or dilated ; sometimes a cough is present ; loss of flesh ; anxious 
expression, and sometimes gastric disturbance. These symptoms vary 
according to the location of the aneurism. 

Prognosis. — The prognosis is unfavorable. The average duration 
of life after the formation of an aneurism is from one to four years. 
Death may come suddenly as a result of over-exertion or anger, when 
the result is a hemorrhage; or it may result from gradual exhaustion. 

Treatment. — Tuffell's treatment consists of absolute rest of mind 
and body, including rest in bed, starvation diet (see page 278) for three 
months at least. Potassium iodide is administered in gradually increas- 
ing doses to the limit. The object of the treatment is to cause the blood 
in the sac to coagulate and to prevent rupture. Surgical treatment con- 
sists in the tying of the artery (when small) on both sides of the aneu- 
rism; puncture and galvanic treatment are also used with more or less 
success. 

APOPLEXY, CEREBRAL HEMORRHAGE, EMBOLISM OR 

THROMBOSIS. 

A stroke characterized by paralysis *and sudden insensibility. 

Causes. — This may be due to cerebral hemorrhage, a bursting of a 
blood vessel in the brain; the escaping blood presses upon the brain and 
causes an injury to the tissues, which results in paralysis. This is the 



418 DISEASES OF ADULTS. 

most common type of apoplexy and seldom occurs before the fortieth 
year, but most frequent in men between the fortieth and the eightieth 
year. The bursting of the blood vessel is often the result of : heredity, 
Bright's disease, gout, rheumatism, chronic alcoholism, syphilis, and 
diseases of the heart and the arteries. Immediate causes of the rupture 
are : acute indigestion, violent physical exertion, fits of rage, and excesses 
of any kind. 

Symptoms of Cerebral Hemorrhage. — The presence of a ruptured 
blood vessel in the brain is usually first announced by dizziness; 
pain in the head; numbness of legs and arms; nosebleed, and fear 
of falling. The attack or stroke may come rather slowly, pre- 
ceded by vomiting; or may come suddenly with coma, insensibility, and, 
if standing at the time, the sufferer falls to the ground with the muscles 
relaxed; breathing is irregular, slow, and noisy, the noise being caused 
by paralysis of one cheek, which flaps in and out with the breathing; 
pulse is full and slow, and there is throbbing of the large carotid blood 
vessels (in the neck). The face is very red; the pupils of the eyes either 
contracted or dilated, but not influenced in size by the action of a light 
placed before them. There is always more less fever. 

Prognosis. — The attack usually lasts for from one-half an hour to 
five or six hours. If it extends to more than twenty-four hours, with 
insensibility, the termination will probably be fatal. Generally the effects 
are felt for several weeks, the mind then clears up, the headache ceases, 
there may be partial or full recovery from the paralysis, and this condi- 
tion may last for some years. But there is always danger of another 
attack with increasing probability of a fatal termination. 

Symptoms of Thrombosis. — These come on gradually and are per- 
sistent. There are drowsiness; headache; dizziness; loss of conscious- 
ness ; paralysis of at least one side of the face ; later, paralysis of the arm, 
and one by one the other parts, until, within twenty-four or thirty-six 
hours from the time of the first symptoms, there is paralysis of the entire 
one half of the body. The paralysis may develop without loss of con- 
sciousness. The mental impairment is greater than in cerebral hemor- 
rhage. The patient is profoundly emotional, weeping and sighing fre- 
quently. 

Prognosis of Thrombosis. — While there is frequently some im- 
provement in the paralytic condition, the case eventually proceeds, per- 
haps years after the attack, to softening of the brain and general paraly- 
sis ; and the patient dies either in a comatose state or in convulsions. 



EMBOLISM. ' 419 

Symptoms of Embolism. — This condition develops suddenly, with 
twitching of the muscles, dizziness, more or less mental confusion, head- 
ache, loss of consciousness, paralysis of one side of the body, usually the 
right side. 

Prognosis of Embolism. — After some weeks there may be a com- 
plete recovery. This is characteristic of the mild cases in which the 
symptoms are less grave in nature. In the serious form, death may 
result in a day or two from plugging of the large blood vessel. This 
state is to be feared when the insensibility lasts for a long time — twenty- 
four hours or more. The patient may regain consciousness; but passes 
through progressive stages of dementia, softening of the brain, and 
aphasia (the inability to remember words). Death finally ensues from 
exhaustion. 

Treatment. — If there are warnings of the approach, the efforts are 
directed towards reducing the pressure of the blood on the vessels of the 
brain. This is done by bloodletting and a brisk purgative such as : — 

Epsom Salts, 2 ounces. 

Glycerine, 1 ounce. 

Boiling Water, 3 ounces. 

Give with great care as an enema. 

Leeches may be applied to the mastoid process (the large eminence 
behind the ear). 

If the attack is sudden, at once loosen the clothing around the neck 
and throat so that the blood vessels are not restricted. Place the patient 
in a cool, quiet room. Let him lie rather on his side, with face turned 
a little downward to prevent the tongue from falling back and obstruct- 
ing the breathing. Slightly raise the head and shoulders. Apply an 
ice bag to the head. Bloodletting should quickly follow to relieve the 
brain pressure, and a cathartic is to be given. In insensibility this is 
best given in the form of : — 

Croton Oil, 1 to 3 drops. 

Glycerine, 15 drops. 

Place this with a medicine dropper well back near the root of the 
tongue to insure that it will be swallowed. 

If, during the attack, the face becomes very pale and the pulse irreg- 
ular, give stimulants such as 

Aromatic Spirits of Ammonia, y 2 teaspoonful 

in water very cautiously. 



4 20 DISEASES OF ADULTS. 

The fever may be reduced by an alcohol sponging (page 253). 

The blood clot formed in the brain must not be absorbed too quickly, 
lest hemorrhage ensue. For this purpose give : — 

Solution of Arsenite of Potash 5 drops. 

Syrup of Lacto-phosphate of Lime, 2 drams. 

One such dose three times a day. 

The diet must be liquid or semiliquid (page 278) The patient must 
be kept scrupulously clean, his wants must be inquired into, if power of 
speech is wanting or impaired, and every attention paid to him in his 
helpless condition. 

Electric treatment is beneficial for paralysis. Massage and warm 
salt baths are effective (page 270). 

In Embolism and Thrombosis, rest, and the same position as directed 
in cerebral hemorrhage. Place ice to the head for relief of headache and 
control of hemorrhage or inflammation. To promote absorption of the 
blood and to re-establish circulation give : — 

Ammonium Carbonate, 3 drams. 

Ammonium Iodide, 3 drams. 

Solution of Ammonium Acetate, 4 ounces. 

Give one teaspoonful in half a glass of water three or four times a 
day. This is to be continued for a long period. 

If syphilis is determined as the cause of the disease, remedies such as 
iodide of potassium or of soda and mercury are to be given under the 
careful guidance of the attending physician. 



EPILEPSY. 

Epilepsy is a form of disease which receives its name from the sud- 
denness of its attack. It is also called the falling sickness, because the 
patient, if standing, suddenly falls when an attack comes on. By the 
ancients it was called the sacred disease, from being supposed to be due 
to the influence of the gods or evil spirits. 

Causes. — Among the causes which give rise to epilepsy are external 
injuries done to the brain by blows, wounds, fractures, and the like; 
or pressure from water on the brain, and tumors. Violent affections of 
the nervous system, sudden frights, strong mental emotions, acute pains 
in any part, worms in the stomach or intestines, teething, suppression of 



EPILEPSY. 421 

the menses, excesses and masturbation, are causes which also produce 
epilepsy. Sometimes it is hereditary. 

Prognosis. — When it arises from hereditary predisposition, or comes 
on after the age of puberty, or when the attacks are frequent and of long 
duration, it is usually difficult to effect a cure ; but when it occurs in early 
life, or is occasioned by worms or any other accidental cause, it may be 
remedied. 

Symptoms. — The attack is usually without warning. The patient 
may be in his ordinary health, engaged, perhaps, in his usual occupation, 
when all at once he utters a piercing scream, and falls to the ground. 
Immediately thereafter the face becomes violently distorted, the head is 
usually drawn to one side, the eyes are set and staring, or roll wildly 
about, the color of the skin becomes dark and livid, and the veins swollen 
and turgid; there is frothing at the mouth; the muscles of the lower jaw 
act violently, producing gnashing of teeth, and frequently the tongue is 
injured; the arms are sometimes thrown violently about, and the lower 
limbs may be agitated in a similar manner, while the fingers with great 
power clutch at whatever comes in their way. The breathing is at first 
heavy and difficult, but afterwards it becomes short, quick, and sterto- 
rous, and is often accompanied with sighing and moaning. One side of 
the body is commonly more agitated than the other. After a longer or 
shorter period, the convulsive movements gradually diminish, and the 
patient seems to recover a faint glimmering of consciousness; but the 
look which he casts around is stupid and heavy, and he goes off into a 
lethargic sleep, from which he does not awake for some hours. There is 
no consciousness of anything that occurred during the paroxysm. On 
coming out of the fit, there is generally headache and always languor, 
and it may be days before he fully recovers from the effects of the attack. 
The duration of the paroxysm is usually from five to ten minutes; but 
sometimes several attacks follow one another in succession, and it may be 
then protracted for several hours. The most frequent, perhaps, of the con- 
sequences of confirmed epilepsy is insanity, either in the form of acute 
mania or monomania following the attacks, or of gradual imbecility, 
without any acute seizure. Though the fit usually comes on suddenly, 
yet there is sometimes distinct warning of its approach. It varies in 
different individuals, and may be lowness of spirits, irritability, dizziness, 
noises in the ear, floating specks before the eyes. There is, however, a 
particular sensation which is said to be felt by some immediately before 
the attack, and which is known as the aura epileptica. It is variously 



422 DISEASES OF ADULTS. 

described as resembling a current of air, a stream of water, or a slight 
convulsive tremor, commencing in one of the limbs, and proceeding up- 
wards to the head, when the patient is deprived of all consciousness. 
Epilepsy is commonly divided into idiopathic, when it is a primary dis- 
ease, depending on some affection of the cerebro-spinal system; and 
sympathetic, when produced by an affection in some other part of the 
body — as the stomach, bowels, liver, circulating system, etc. 

Treatment. — During the attack, the principal thing is to see that 
the patient does no self -in jury — especially a piece of cork ought to be 
placed between the teeth, to prevent injury to the tongue ; the dress should 
be loosened about the neck and chest ; the head, if possible, a little raised ; 
and a free circulation of air maintained. Where the disease can be 
traced to any special exciting causes — as injuries of the head, worms, 
teething, etc., — the treatment should first be directed to its removal. 
When a plethoric state appears to occasion the disease, the patient's diet 
is to be restricted, frequent purgatives are to be administered, and every- 
thing avoided that may determine the blood to the head. If there are 
marks of debility, a generous diet, with tonic medicines and other means 
of strengthening the system, will be proper. The cold shower bath is 
recommended if it can be well borne, otherwise the tepid bath. The oil 
of turpentine, in frequent doses of one-half to one dram, is said to be 
of service in many cases. Bromide of potassium is a very valuable 
remedy, given in doses of ten to twenty grains three times a day. Stimu- 
lants, particularly ether, are said occasionally to keep off an attack. In 
this disease great care is necessary in the matter of diet, and moderation 
in quantity and quality are material points. When the appropriate 
remedies are judiciously employed, and the proper regimen strictly 
adhered to, epilepsy is often permanently cured, and the suffering is 
greatly mitigated even in those forms which do not admit of cure. 

Eclectic Treatment for Epilepsy. — Observe the same general treat- 
ment as before recommended. Give an emetic. The following is a good 
one: — 

Pulverized Lobelia, i ounce. 

Pulverized Bloodroot, . . . .y 2 ounce. 

Seneca, i scruple. 

Ipecac, 6 drams. 

Cayenne, 4 scruples. 

Mix. Dose, half a teaspoonful in warm water; repeat three or four 
times, at intervals of fifteen minutes. 



CONCUSSION OF THE BRAIN. 423 

Bathe the feet and legs in warm water; apply mustard poultices to 
the nape of the neck ; keep the bowels open ; and remove all tight band- 
ages, and give plenty of fresh air. An excellent preparation is the 
following : — 

Peony, 1 ounce. 

Peruvian Bark, 1 ounce. 

Valerian, ' 1 ounce. 

Snakeroot, Yi ounce. 

Simmer them together in two quarts of water till reduced to one; 
add one pound of sugar. Give the patient from one-half to a wineglass- 
ful three times a day. 

On the approach of a fit, give a teaspoonful of fine salt three times 
a day; it will shorten the patient's sufferings. A person liable to this 
affliction should exercise the greatest caution in regulating the passions. 



CONCUSSION OR INFLAMMATION OF THE BRAIN. 

The result of a shock, blow, or other injury upon the brain without 
any outward appearance of a w T ound. 

Causes. — This is nearly always produced by a blow or a fall; it is 
one of the most frequent injuries to which the brain is exposed; it may 
be either slight or severe, in proportion to the severity of the exciting 
cause; in the former case the effect is but momentary — the patient is 
stunned, but very soon recovers consciousness, and perhaps feels no 
more of it, except a little tenderness of the part struck. It should be 
borne in mind that concussion of the brain is not always the result of a 
blow ; it may be produced by a violent shock to the nervous system, such 
as that caused by coming down heavily on the feet from a leap. 

Symptoms. — Among the symptoms of inflammation of the brain, or 
its investing tissues, may be mentioned as prominent : Shivering, suc- 
ceeded by heat in the skin ; great thirst ; tongue furred ; pain in the head ; 
intolerance of light; bloodshot eyes, with a wild, wandering look; sick- 
ness, and delirium. There may be violent and obstinate vomiting, as 
a first symptom, followed after a time by others. In the latter case he 
remains unconscious, without the power to move or speak; the pulse is 
slow and feeble, the breathing difficult, frequently there is vomiting, and 
an unnatural contraction or dilation of the pupils of the eyes. 



424 DISEASES OF ADULTS, 

Prognosis. — If it is simple concussion, a fatal termination is not 
likely; but sometimes the shock causes rupture of the substance of the 
brain itself, or its inclosing membranes, or of one or more of its blood 
vessels, causing effusion; in this case the patient may never rally from 
his state of stupor, or, if he does, it will be but for a short time; there 
will probably be convulsions, paralysis, and other symptoms resembling 
apoplexy. All these are characteristic of inflammation. In so sensitive 
an organ as the brain, it must be evident that an inflamed state of the 
tissues is by all means to be avoided; hence, when reaction sets in after 
the stunning and depressing effects of concussion have passed off, keep 
the head cool and the patient quiet. 

Treatment. — In this case but little can be done beyond putting the 
patient to bed, and keeping the surface of the skin warm by friction and 
hot applications ; when there is extreme depression, a little brandy or sal 
volatile may be given, but very sparingly, because, if death does not 
ensue, there will be reaction, with an inflamed state of the organ. If a 
physician is not within reach, and the alarming symptoms increase in 
intensity, the hair of the head should be cut or shaved off, and towels 
wet with cold water applied; if iced, so much the better. A thorough 
cathartic should be given. To reduce the pulse and cause perspiration, 
give four drops of tincture of veratrum, in a little sweetened water, every 
hour, till the desired results are produced. 



INFLAMMATION OF THE OUTER COVERING OF THE 
BRAIN OR PACHYMENINGITIS. 

Causes. — Fracture of the skull; necrosis (death) of the bones of 
the head; penetrating wounds in the head; chronic alcoholism; Bright's 
disease; syphilis; erysipelas, and tuberculosis. 

Symptoms. — These are always obscure and the diagnosis is often 
extremely difficult. Dizziness; headache; sensitiveness of the eyes to 
light ; delirium ; convulsions ; coma ; apoplectic strokes ; epileptic fits, and 
paralysis, are among the most frequent indications of this condition. 

Prognosis. — Death usually terminates the condition. 

Treatment. — This is purely symptomatic and must be adapted to the 
conditions as they arise. Surgical attention, especially trephining, offers 
hope of a favorable ending in some cases, especially those caused by 
wounds of the head. 



MENINGITIS. 425 

ACUTE MENINGITIS, CEREBRAL OR BRAIN FEVER. 

Inflammation of the inner and middle coverings of the brain, with 
an exudation from the blood vessels. It is most frequent in young 
persons and in males. 

Causes* — Infectious fevers ; erysipelas ; typhoid fever ; influenza ; 
pneumonia; diphtheria; disease of the middle ear, and of the bones of 
the head; abscess of the brain; overwork; insomnia of long duration; 
acute alcoholism; sunstroke; syphilis, and a micro-organism. 

Symptoms. — Headache; general irritability; weakness; dizziness; 
vomiting; constipation; fever, and coated tongue. Then follows the 
stage of invasion. The fever rises to from 103 to 104 ; pulse from 
100 to 120; face, flushed; eyes, congested; headache, intense and con- 
tinuous ; ringing in the ears ; intense sensitiveness to light ; delirium, and 
intense sensitiveness of the skin. 

The second stage, or period of excitement, lasts for from one to 
fourteen days, and is marked by an increase of all symptoms ; rolling of 
the eyes ; delirium amounting almost to mania ; twitching of the muscles 
of the face; bending back the head; arching the body backward, and 
occasional outcry. Drawing the finger nail across the abdomen leaves 
a red line characteristic of this disease. 

The third stage, or stage of depression or collapse, follows. It is 
marked by paralysis; the patient becomes quiet; delirium and muscular 
contortion subside ; sleepiness ; coma ; fever abates ; pulse, slow and irreg- 
ular; the sphincter muscles relax and the urine and the faeces are voided 
involuntarily, and the breathing is jerky. 

Prognosis. — Death usually follows on the first or second day of the 
third stage.- Should a patient survive he is usually less mentally bright, 
and is likely to suffer much from headache and epilepsy. 

Treatment. — Absolute rest in bed in a dark and well-ventilated 
room. The head elevated and ice applied to it. Only liquid food is 
given. When the patient is unconscious, or unable to swallow, it must 
be given by the rectum (page 235). Delirium and convulsions are con- 
trolled by narcotics administered by the physician. Vomiting is relieved 
by doses of chloral. The fever and high temperature are controlled by 
sponge baths and rubs (see page 253). Leeches or fly-blisters behind 
the ears, at the back of the neck, and on the temples are of service in 
relieving the blood flow to the brain. Venesection (bloodletting) is 
often resorted to. 



426 DISEASES OF ADULTS. 

NERVOUS PROSTRATION OR NEURASTHENIA. 

A condition of nerve-tire or exhaustion attended by an inability or 
lack of desire to attend to ordinary work and duties. 

Causes. — Excessive nervous and mental strain; overwork; emotion; 
alcohol; tobacco; combined fatigue and mental anxiety; nervous tem- 
perament and heredity. 

Symptoms. — Irritability of temper; mental weakness; inability to 
concentrate the attention : attempts to engage the mind are attended by 
headache, dizziness, restlessness, fear, depression of spirits, and physical 
weariness. There are a persistent feeling of pressure on the head; dis- 
turbance of sleep, either insomnia or unrestful slumber; pain in the 
back; dyspepsia, and mental disorders. 

Prognosis. — If the unfavorable conditions which have brought about 
the condition can be removed, the outlook is favorable ; but the cure may 
take a very long time, and the patient is usually in some measure per- 
manently affected by the attack. 

Treatment. — The ''rest cure" as first suggested by Dr. S. Weir 
Mitchell is the only rational and curative treatment that can be given. 
The efforts must be directed to restore to the patient the loss of nervous 
energy to which his condition is due. It is almost hopeless to attempt 
to give the required degree of rest and upbuilding at home. A sani- 
tarium or hospital must be chosen and the patient submit himself to the 
discipline of his attendants. But if home conditions are very good, and 
the patient can have a trained or otherwise competent nurse to devote 
entire time and attention to his welfare, a cure can be effected. The 
patient is not allowed to sit up. but must have perfect physical and mental 
rest in bed. He must not receive or write letters nor read, for this is 
using up the nervous and muscular energy which is sought to be restored. 
Lack of exercise is to be made up by daily massage. Electric treatment 
once a day is also beneficial. This is to be supplemented bv bathing 
(^see page 251). The food is to be nourishing and easily digested. It is 
best given in small quantities at intervals of about three hours. 
An excellent tonic for this condition is : — 

Fluid Extract of Coca, 2 drams. 

Dilute Phosphoric Acid, 6 drams. 

Tincture of Nux Vomica 1 dram. 

Syrup of Ginger iy 2 ounces. 

Peppermint Water to make 6 ounces. 

Take a tablespoonful in water after each meal. 



LOCO-MOTOR ATAXIA. 427 



LOCOMOTOR ATAXIA. 

A disease causing degeneration of the spinal cord and nerve roots, 
resulting in loss of control of the muscles. 

Causes. — Syphilis; alcoholism: exposure: and wounds or injuries 
are the principal, direct or indirect, causes of the disease. 

Symptoms. — There are three stages of the disease: 1. Loss of 
se::sation; 2. Inability to direct or control motion: 3. Paralysis. The 
attack comes on very gradually, and among the first indications are sharp. 
darting pains in the legs and feet: loss of feeling in the feet, such as the 
inability to distinguish between hard and soft substances stepped on : 
if the spinal cord is affected in the upper part there is difficulty in operat- 
ing several sets of muscles in the fingers at the same time, such as are 
demanded in the act of buttoning the clothing. A tingling or burning 
is felt on the surface of the body in the waist, legs. feet, knees, and 
?.::kies. There is also a tightened feeling around the waist as though a 
belt were tightly strapped about it. The inability to operate more than 
one set of muscles at a time is called lack of coordination, and is notice- 
able in an attempt to walk in a straight line. This test is usually applied 
in the early stages by directing the patient to try to do so with the eyes 
dosed. The patient is also asked to stand with the feet close together 
and to close the eyes : if the disease is begun he will have great dimculty 
in standing erect in such a position, but will sway about and perhaps 
fall. There is no loss of power in the muscles but simply an inability 
to control the movements of the limb. The optic nerve is affected early 
in the progress of the disease, and the sight is affected in the direction 
of color-blindness or in double vision. These symptoms become more 
and more pronounced as the disease advances, especially in the way of 
loss of sensation, until the patient is unable to feel a pin prick in the feet. 
There is also considerable emaciation: ulcers on the feet: loss of hair; 
and sensations of pain in many parts of the body, caused by certain 
organs becoming affected by the progress of the disease. There may be 
griping pains and vomiting; pain in urinating; pain in the rectum, with 
hemorrhoids : spasms of coughing ; difficult}" in breathing and constriction 
of the pharynx; and pains in the region of the heart. The disease leads 
up ultimately to paralysis, and in rare cases is attended by loss of mental 
power. 

Prognosis. — The outlook is unfavorable; the disease may extend 



428 DISEASES OF ADULTS. 

over a period of several years ; there may be times when recovery seems 
possible; but the termination is death. 

Treatment. — Absolute rest in bed; excitement, mental distress and 
worry, and excesses are to be avoided; and the treatment should be 
directed towards the improvement of the general health. To this end 
the diet must be nutritious, and cod-liver oil, hypophosphites, and strych- 
nine are to be given. If syphilis is the cause, that is to receive its special 
form of treatment. Massage and clearly defined forms of exercise are 
of benefit. Frankel's system of exercises aims to teach the patient the 
control of his muscles all over again as though this had been forgotten. 
This is the correction of the lack of coordination of muscles. There are 
many varieties of exercises which will produce great benefit. Among 
others a plank is arranged with a number of cup-like hollows placed 
along its length at intervals and numbered; this is placed at the foot of 
the bed and the patient is directed by the nurse to place his heel in such 
and such a number. A chalk line is drawn along the floor and he is 
required to walk as nearly along it as he can. A small flight of stairs 
is used with a railing on each side for support ; the patient walks up one 
or two steps and down on the other side by using his legs without assist- 
ance from his hands. These and many other ingenious forms are fol- 
lowed, not to an exhausting degree; and while they are not curative of 
the disease, they teach control of the movements, and in conjunction with 
massage they keep up the muscular tone of the limbs and encourage the 
patient. Baths, both plain and medicated, are of great service; but the 
cold bath should be employed only when the vitality is great enough to 
recover from its stimulating effects. Electricity in some of its several 
forms of applications is also of benefit in many cases. Certain mechan- 
ical devices have been employed in the form or harness by which the 
strain was removed and transferred, but they are not now used. 

PALSY OR PARALYSIS. 

The total loss or diminution of motion or sensation, or both, in any 
part. There are several kinds of palsy or paralysis, such as the paralysis 
agitans, the shaking, or, as it is sometimes called, from the peculiarity 
of the patient's gait, the dancing palsy ; hemiplegia, when one side of the 
body only is smitten ; and paraplegia, when it is the lower half which is 
more or less deprived of its nervous power; but in all cases it is the 
brain which is the seat of disorder; and if this is confined to one of its 



PALSY OR PARALYSIS. 429 

hemispheres, the attack, if it does not include both sides, is most likely 
to fall on the opposite side of the body. 

Causes. — The rupture of a vessel of the brain is one of the most 
common causes of paralysis, and this may occur without there being any 
decided apoplectic symptoms. A slight transient faintness, and confu- 
sion of ideas, may precede the attack, or it may come on during sleep, 
so that the patient may only be made aware that he is paralyzed by his 
inability to speak plainly, or to move a limb, or one side of his body. 
Sometimes the attack is gradual, and occupies a considerable time, — 
days, weeks, and even months elapse before the loss of nervous energy 
becomes complete ; and this helplessness may be produced by a succession 
of slight shocks, as it were, or by the gradual stealing on of an appar- 
ently torpid condition. This latter is more commonly the case when the 
disease arises from a decided state of general debility, which in time 
involves the brain, until the structure gives way and softening is the con- 
sequence. Hard drinkers, and others whose lives or habits necessitate 
a frequent state of cerebral excitement, are liable to this disease. With 
such the progress of the disease is generally rapid. 

One of the chief causes is pressure upon or disease of the brain or 
spinal cord. When confined to the lower part of the body, there may 
be reason to believe that the defect of power is in some cases but func- 
tional. In this case the cause may be long exposure of the lower limbs 
to wet and cold, self -abuse, excessive indulgence in venery, inflammation 
of the bowels or kidneys, effusion in the spinal cord from a blow, a burn, 
or other injury; disease of the womb, or of the urethra, may also give 
rise to it. Palsy of either of the limbs may be caused by pressure, and 
general palsy by the action of lead or mercury upon the system; there- 
fore those who work in these metals are peculiarly liable to be so affected, 
such as button gilders, glass silverers, plumbers, etc. The most danger- 
ous form of this kind is when it affects the muscles of respiration, in 
which case it rapidly proves fatal. 

Symptoms. — Among the premonitory symptoms of paralysis may 
be named headache, confusion of ideas, loss of memory, impaired vision, 
drowsiness, and partial stupor, with, frequently, numbness, and pricking 
or tingling sensation in the limb or part about to be attacked. With 
persons of a full habit, there will be heat and flushings in the face, and 
most of the signs of an approaching fit of apoplexy; then follow indis- 
tinct articulation, loss of power, and the other marked and unmistakable 
indications of an actual attack. 



430 DISEASES OF ADULTS. 

Treatment. — A proper treatment, in the case of a patient of a full 
habit, is strong purgatives — about five grains of calomel, followed by 
senna mixture, or croton oil pills, every four hours, until they operate 
freely. When there is faintness and confusion of intellect, give a tea- 
spoonful of sal volatile in a glass of water, and repeat it in an hour, if 
required; no alcoholic stimulants should be administered; put the feet 
and legs in a hot mustard bath, and place the patient in a warm bed, 
with head and shoulders well raised. After they have once acted well, 
keep the bowels gently open with rhubarb or castor oil; let the diet be 
spare, and the quietude of the patient as perfect as possible. After the 
acute stage of the disease has passed, local stimulants should be used, and 
the affected parts well rubbed with the hand or a flesh brush. Electricity 
and galvanism may also be employed where there is no reason to suspect 
structural disorganization. In paraplegia it is often very difficult to get 
the bladder to act ; and when it does, the urine flows from it involuntarily. 
Great attention should be paid to this, and stimulant diuretics given ; the 
tincture of cantharides, in ten drop doses, is perhaps the best. 

Sulphur baths and chalybeate waters often afford relief. 

In palsy of the face, if it is caused by a blow or cold, hot fomentations 
and stimulating liniments should 'be applied; as also in palsy of the 
hands, fingers, or other extremities, with electro-magnetism, persevered 
in for a considerable time. In all cases of chronic paralysis, it should be 
borne in mind that the nervous system requires arousing and stimulating 
to a due performance of the functions necessary to life. In nearly all 
there is a sluggish action of the bowels, which are often obstinately con- 
stipated, and require the strongest purgatives to keep them at all open. 
It is sometimes better to employ enemas than continue giving drastic 
medicines. The paralytic patient frequently enjoys pretty good general 
health, and eats heartily ; and this increases the above difficulty, especially 
if the patient is a heavy person, with little power of self -movement. 
When confined entirely to bed, sores and sloughing ulcers are not un- 
common ; an air or water bed greatly obviates the danger of them. 



INFLAMMATION OF THE JOINTS OR ARTHRITIS. 

Inflammation of the large joints of the body, chiefly the knee, elbow, 
hip, and sometimes the ankle. It is marked by the increase of liquid 
around the joint, attended by redness, swelling, and pain. 



INFLAMMATION OF THE JOINTS. 431 

Causes. — There are a variety of forms due to rheumatism, gout, 
gonorrhoea, injuries, syphilis, and the tubercle bacillus of consumption. 

Symptoms. — Marked redness; pain; swelling; fever in the joint; 
and indications of the flow of liquid into the part. The pains are indica- 
tive of the nature of the affliction, whether rheumatic, gouty, or tuber- 
cular. In tubercular inflammation, called white swelling, there is a 
gradual disintegration of the joint with a slow-forming, indolent, swell- 
ing* caused by the Bacillus tuberculosis. There is suppuration, which 
affects the ends of the bones and the cartilages. These latter sometimes 
are completely destroyed by the inflammatory conditions so that the ends 
of the bones which form the joints are not separated but strike together 
causing intense pain. 

Treatment. — There must be perfect rest to the joint and the patient 
must not bear the weight of the body upon it. All attempts to use the 
joint only irritate the already much-inflamed tissues and increase the per- 
nicious condition. The internal treatment must be that suggested by 
the disease which causes the swelling. 

Local applications include cold ice and compresses to reduce the in- 
flammation; counter-irritants such as blisters, cautery, etc., to promote 
absorption of the fluid; extension apparatus, and immovable splints to 
keep the inflamed surfaces apart, and to prevent motion; and surgical 
operation in tuberculosis cases such as hip joint disease and similar affec- 
tions. (For cold applications and counter-irritants, see page 256.) A 
local application for white swelling is : — 

Powdered Gum Ammoniac, 2 ounces. 

Vinegar of Squill, Enough to form a paste. 

Spread upon a piece of leather and apply daily to the joint. 

Hip Joint Disease. — This generally occurs in children of a scrofu- 
lous habit. It prevails in cold, moist climates, and usually attacks chil- 
dren between the ages of seven and fourteen, though it is frequently met 
with before and after that time of life. 

Symptoms. — The first symptom complained of is generally pain in 
the knee. Sooner or later the patient is observed to walk awkwardly 
and less vigorously than usual. Pain is felt in the hip joint itself, and, 
though aggravated by motion, often becomes more severe from time to 
time. Collections of matter make their appearance, most frequently in 
the outer wall of the hip, but occasionally in the groin and hip. The 



432 DISEASES OF ADULTS. 

patient, after a tedious illness, recovers with a stiff joint, and wasted or 
shortened limb. 

Treatment. — As this disease is generally pretty far advanced before 
it is discovered, but little can be done for it in the way of domestic treat- 
ment. A surgeon should be consulted. As a general rule, counter exten- 
sion may be used to advantage. 

STIFFNESS OF JOINTS OR ANCHYLOSIS. 

This may be caused by the introduction of the larva of an insect, 
or from a violent blow or fall, either of which will often bring on an 
inflammatory action, with an exudation and deposit of gritty matter, 
which settles between the bones forming the joints, and thus prevents 
their free movement. 

Treatment. — Take a vessel sufficiently deep to admit of the immer- 
sion of the leg up to above the knee. Nearly fill it with water of the 
temperature of 98 , and pour in a strong decoction of elder flowers and 
tar. Take this bath night and morning; and apply to the affected part, 
three times a day, compresses saturated with the following lotion : — 

Liquor of Ammonia, 2j^ ounces. 

Camphorated Alcohol, 3 drams. 

Bay Salt, 1 J4 ounces. 

Water, 1 quart. 

Mix. The compresses should remain on for ten minutes at a time. 
Afterwards apply a plaster made as follows : — 

Lard, 10 ounces. 

Yellow Wax, 3 ounces. 

Mix these over the fire, with just sufficient hot water to form a mass; 
and add grated camphor, three ounces. Remove from the fire and let 
it cool. When sufficiently congealed, spread it with the blade of a knife 
or the handle of a spoon upon a piece of linen of the size required ; and 
cover the whole with oilskin. Or, bathe the part night and morning with 
warm salt and water ; rub well in, two or three times a day, almond oil ; 
and, at the same time, endeavor by gentle movement to loosen the joint. 

RHEUMATIC FEVER OR ACUTE ARTICULAR RHEUMATISM. 

An infectious, but not contagious, disease which affects the large 

joints of the body, and is by some called acute inflammatory rheumatism. 

Causes.— There is clear evidence that the disease is caused by an 



RHEUMATIC FEVER. 433 

infectious micro-organism. The predisposing causes are exposure to 
dampness and cold ; wearing wet clothing ; living in damp localities ; sud- 
den fall of temperature; enfeebling fevers and other diseases; male sex; 
and previous attacks. The disease is seldom seen in persons under ten 
or over fifty years of age. It is most common between the ages of 
twenty-five and thirty-five. 

Symptoms. — The attack is usually sudden and comes on at night; 
there are chills; pain and stiffness in the joints; loss of appetite; usually 
moderate, but sometimes very high, fever; the perspiration is profuse 
and the sweat is of an acid reaction with a peculiar odor. There are 
thirst ; scanty urine ; constipation ; and excess of urates in the urine. The 
pain and the perspiration prevent sleep ; the patient is exhausted and the 
skin is covered with rash or prickly heat caused by excessive perspiration. 
The pain is intensified by efforts to move; the larger joints are affected; 
those of the fingers and toes usually escape; there are heat, redness, and 
swelling at the joints; and the inflammation skips about from one to 
another joint. But the joints are affected in regular order, that is, both 
knee joints, both elbow joints, at the same time. The duration of an 
attack is from thirteen to twenty-one days when not attended by com- 
plications. These may prolong the attacks for five or six weeks; and 
relapses are to be expected. 

Prognosis. — Recovery is the rule in simple cases. Xot more than 
three per cent of the cases terminate fatally; but in complicated cases 
the mortality is higher, depending upon the nature of the accompanying 
disease. 

Treatment. — Absolute rest in a bed provided with blankets only. 
Sheets are not to be used. The clothing worn by the patient should also 
be of wool, and the bed-clothing must be arranged so as not to press 
upon the inflamed joint. The diet should be a milk diet, and at no 
time should food which is difficult of digestion be given. The patient 
should be encouraged to drink copiously of water for the purpose of 
flushing out the kidneys to carry off the poison of the disease. 

There should be a dose of calomel followed by a saline purgative such 
as Hunyadi Janos water, Epsom or Glauber's salts. Salicylic acid or 
some of the salicylates are of great benefit : — 

Salicylic Acid, Yz ounce. 

Solution of Acetate of Ammonia, 4 ounces. 

Sweet Spirits of Niter, 1 ounce. 

Simple Syrup, 1 ounce. 

Take a tablespoonful in a wineglassful of water every three nours. 



434 DISEASES OF ADULTS. 

Or:— 

Salicylate of Soda, i ounce. 

Compound Tincture of Cinchona, 3 ounces. 

Peppermint Water, 3 ounces. 

Take a dessert-spoonful at first every three or four hours. On signs 
of relief from it, increase the intervals to every six hours. 
Or:— 

Acetate of Potassium, 1 ounce. 

Salicylic Acid, y 2 ounce. 

Lemon Syrup, 2 ounces. 

Peppermint Water, 8 ounces. 

Take a tablespoonful in a wineglass of water every three hours. If, 
after five or six days of such treatment, there is no improvement, it is 
likely that salicylates are not the treatment required and that they will 
not cure. It is well then to give : — 

Potassium Iodide, 4 scruples. 

Elixir of Cinchona, iy 2 ounces. 

Infusion of Gentian, 1 y 2 ounces. 

Water, 1 ounce. 

Take a dessert-spoonful in water every three or four hours. 
Or:— 

Wine of Colchicum Root, 10 drops. 

Iodide of Potassium, 15 grains. 

Take one such dose three or four times a day. 
The joints may be well anointed with : — 

Icthyol, 1 ounce. 

Lanolin, 1 ounce. 

and the joints may be wrapped in cotton batting. 
Or:— 

Bicarbonate of Soda, 2 ounces. 

Laudanum, ^2 ounce. 

Boiling W^ater, 2 pints. 

Moisten flannel cloths with the above and wrap them around the 
joints. When the pain in the joints is great and they are inflamed, 
blisters of the size of a silver dollar are to be placed around the joint. If 
the pain persists : — 

Mercurial Ointment, y 2 ounce. 

Belladonna Ointment, y 2 ounce. 

Apply locally to the joints. 



MUSCULAR RHEUMATISM. 435 

There is very great danger of heart complications ensuing from an 
attack of rheumatic fever, and the danger exists for two or three weeks 
after apparent recovery. It is therefore absolutely necessary that the 
patient remain in bed for some days after he is apparently well. Going 
out under two weeks after he is able to sit up is running a great risk. 
The exertion of attention to business is too great a demand upon the 
weakened heart's action, and, even though immediate affections are not 
noted, there is danger of sowing the seeds of chronic heart disease for 
the future. 

MUSCULAR RHEUMATISM. 

An acute or chronic inflammatory affection of the muscles, marked 
by pain, stiffness, and tenderness of the muscles. 

Causes.— It is nearly always caused by exposure to cold, damp, or 
direct drafts of cold air. A previous attack is a predisposing cause ; and 
it affects adults only. 

The varieties of muscular rheumatism are : — 

Rheumatic Headache. — (See page 308.) 

Wry Neck or Stiff Neck or Torticollis, which is rheumatism of the 
muscles of the neck. It generally affects only one side of the neck and 
back of the head. The head is twisted towards the affected side, and 
great pain attends any effort to turn it straight. 

Rheumatism of the Thorax affects the muscles of chest and the 
intercostal (between the ribs) muscles. Deep breathing, coughing, and 
sneezing increase the pain. 

Lumbago is rheumatism in the mass of muscles at the back. It is 
one of the most common forms, and usually involves both sides. All 
attempts to move greatly aggravate the pain. When it occurs in com- 
plication with sciatica the pain is intense. 

Prognosis. — This is always favorable. 

Treatment. — Rest is the first essential. Hot poultices composed of 
two-thirds pilocarpus leaves and one-third flaxseed meal are to be applied 
to the muscles affected. They are to be changed every two hours. For 
internal administration give : — 

Antipyrine, 10 grains. 

One such dose every three hours. 

Or:— 

Salicylate of Strontium, 10 to 15 grains. 



436 DISEASES OF ADULTS. 

One such dose three times a day. 

If the rheumatism has been caused by cold, a very hot or turkish 
bath or a hot pack will remove the pain and stiffness, especially if the bath 
is followed by vigorous massage (pages 256 and 266). 

Acupuncture is often of great relief in difficult cases. 

Where there are great pain and loss of sleep give: — 

Powdered Ipecac and Opium, 10 grains. 

Potassium Nitrate, 5 to 10 grains. 

Give one such dose in the form of a powder night and morning. 
The following is a valuable liniment where only a small area is 
affected : — 

Oil of Wintergreen, I ^ drams. 

Alcohol, 2 ounces. 

Rub thoroughly into the affected part. 

In chronic cases and in lumbago, it is desirable to see that the bowels 
move regularly. Hunyadi Janos water, Epsom or Glauber's salts will 
be sufficient to secure this. 

NEURALGIA. 

A disease of the nervous system marked by sudden, darting, sharp 
pain which follows the course of the nerve. 

Causes. — Neuralgia is usually a result of impoverished nerves, and 
requires the use of nerve tonics. It can frequently be traced to diseased 
growth of the bone about those parts through which the nerves pass; 
and, in some severe cases, it has been found to depend upon the irritation 
caused by foreign bodies acting upon those highly sensitive organs. 

Among its exciting causes we may mention exposure to damp and 
cold, especially if combined with malaria; and to these influences a per- 
son with a debilitated constitution will be more subject than another. 
Anxiety of mind will sometimes bring it on, and so will a disordered 
state of the stomach ; more particularly, a state in which there is too much 
acid. Tea, coffee, tobacco, and opium are prolific causes of neuralgia, 
as well as of other diseased conditions of the nerves. There are several 
forms of the disease, according to the part affected. 

Neuralgia of the Head, Tic douloureux or Fothergill's disease, is 
treated on page 306. 

Neuralgia of the Neck and Arm affects the arm, hand, shoulder, 
shoulder blade, breast, and neck. 



NEURALGIA. 437 

Neuralgia of the Back and Side, or Intercostal Neuralgia, affects the 
parts mentioned. 

Sciatica is neuralgia of the sciatic nerve which runs into the hip, 
inside of the thigh, calf of the leg, ankle, and heel. 

Facial Neuralgia affects the nerves of the face. 

Symptoms. — A violent, darting, and plunging pain, which comes on 
in paroxysms. Except in very severe and protracted cases, there is no 
outward redness nor swelling to mark the seat of the pain, neither is 
there usually constitutional derangement, other than that which may be 
caused by want of rest, and the extreme agony of the suffering while it 
lasts, which may be from one to two or three hours, or even more, but 
it is not commonly so long. Tenderness and swelling of the part some- 
times occurs where there has been a frequent recurrence and long con- 
tinuance of the pain, which leaves the patient, in most cases, as suddenly 
as it comes on. Its periodic returns and remissions, and the absence of 
inflammatory symptoms, are distinctive marks of the disease. 

Treatment. — This must depend upon the cause. If it is a decayed 
tooth, which, by exposure of the nerve, sets up the pain, it should be at 
once removed, as there will be little peace for the patient until it is. If 
coexistent with neuralgia there is a disordered stomach, efforts should 
be made to correct the disorder. If the patient is living in a moist situa- 
tion, he should at once remove to a higher level, and a dry, gravelly soil. 
Tonics, such as quinine and iron, should be given, and a tolerably gen- 
erous diet, but without excess of any kind. In facial neuralgia, blisters 
behind the ears have been found serviceable; and, if the course of the 
nerve which appears to be the seat of the mischief can be traced, a bella- 
donna plaster, or a piece of cotton soaked in laudanum and laid along it, 
will sometimes give relief; so will hot fomentations of poppies or bran 
poultices sprinkled with turpentine. 

An application of chloroform on lint has sometimes proved very 
effectual in relieving severe neuralgic pains, and so has an ointment 
composed of lard and veratrum, in the proportion of six grains of vera- 
trum to one of lard. 

A mixture of chloroform and aconite has been recommended for 
facial neuralgia, the form of preparation being two parts of spirits of 
wine, or eau de cologne, one of chloroform, and one of tincture of aconife, 
to be applied to the gums of the side affected, by means of a finger cov- 
ered with a piece of lint, or soft linen, and rubbed along them, — the 
danger of dropping any into the mouth being thus avoided. When the 



438 DISEASES OF ADULTS. 

pain is connected with some organic disease, as a decayed tooth, or 
chronic inflammation of the gums or of the sockets, or superficial necrosis 
of the bone, substitute tincture of iodine for the spirit in the above 
formula. 

The shower bath, plenty of exercise in the open air, and attention to 
whatever will build up the general health must be carefully attended to. 

Persons at all liable to this painful affection should be extremely 
careful not to expose themselves to wet or cold; above all, not to sit in 
draughts. A very slight cause will often bring it on, where there is the 
least tendency to it. 

One severe and troublesome form of neuralgia is earache. It often 
occurs in children at the time of dentition. It may be distinguished from 
pain of an inflammatory character. 

The following pill, known as Dr. Gross's pill, is of great value in all 
cases of neuralgia : — 

Sulphate of Quinine, 2 grains. 

Sulphate of Morphia, 1-20 grain. 

Sulphate of Strychnia, 1-30 grain. 

Arsenious Acid, 1-20 grain. 

Extract of Aconite, y 2 grain. 

Take one such pill every one, two, or three hours, according to the 
severity of the attack. 
Or:— 

Sulphate of Quinine 2 grains. 

Reduced Iron, 1 grain. 

Arsenious Acid 1-20 grain. 

Aconite, 1-120 grain. 

Take one such pill every four or five hours. 

In intercostal neuralgia the following is of great benefit: — 

Chloral, 1 dram. 

Powdered Camphor, 1 dram. 

Menthol 1 dram. 

Rub together in a mortar, and paint over the affected part with a 
brush as needed. 

In sciatica, 10-grain doses of antipyrine, or phenacetine, may be given 
twice a day. A flannel bandage should be applied to the whole length 
of the affected limb and changed daily. To prevent the pain caused by 
movement of the leg, Mitchell recommends the use of a splint reaching 
from the armpit down to the heel, strapped close to the body and limb. 



ANAEMIA. 439 

Application of a blister to the part along the course of the nerve is also 
beneficial. In extreme pain, narcotic injections will be required. 



ANAEMIA. 

A disease of the blood in which there is a deficiency of red blood 
corpuscles and hemoglobin (the red coloring matter of blood). 

Causes. — Deficient food; impure air; lack of sunshine; overwork; 
worry; prolonged nursing; cancer; Bright's disease; consumption; 
malaria; syphilis; etc. 

Symptoms. — The skin, lips, tongue, gums, and ears are pale ; loss of 
appetite ; capricious appetite ; irritable temper ; depression of spirits ; gen- 
eral weakness ; occasional dizziness and fainting ; palpitation of the heart 
and shortness of breath follow moderate exertion; excited heart action; 
hands, feet, and lower eyelids are puffy; face of a waxy appearance; 
menstruation is irregular, painful, or suppressed; dropsy of the ankles 
is present; and many complications may arise in long continued anaemia. 

Prognosis. — Where the cause can be determined upon and promptly 
removed the outlook is favorable; but in direct or primary conditions 
the prospect is not so good. 

Treatment. — Exercise; fresh air in abundance; sunshine; and a 
nutritious diet are first indicated. Tonics of iron, arsenic, strychnine, 
and quinine are very valuable. Carbonate of iron in from 2 to 5 grain 
doses, Basham's Mixture, or Blaud's pills may be used. In administer- 
ing iron, great care must be taken not to bring about a constipated con- 
dition. Smith's "four chlorides" is an excellent tonic: — 

Corrosive Chloride of Mercury, 1 to 2 grains. 

Solution of Chloride of Arsenic, 1 dram. 

Tincture of Chloride of Iron, 4 drams. 

Dilute Hydrochloric Acid, 4 drams. 

Simple Syrup 4 drams. 

Water enough to make 6 ounces. 

Take one dessert-spoonful in a wineglass of water after meals. 

Chlorosis or Green Sickness is a form of anaemia, of unknown cause. 
The number of red blood corpuscles is normal, but the percentage of 
hemoglobin in each corpuscle is deficient. It is a disease to which boys 
and girls in their early teens are subject, but it is more common among* 
girls than among boys. The skin has a more or less greenish, gray, or 
muddy tint. The patient is dull ; there is a pain at the pit of the stomach ; 



440 DISEASES OF ADULTS. 

and dark circles around the eyes. Menstruation is delayed, scanty, and 
irregular as well as painful. Constipation is common. 
Treatment. — Practically the same as in anaemia. 



CEREBRAL ANAEMIA. 

A decrease of the supply of blood in the vessels of the brain. It is 
either general or partial. 

Causes. — Partial anaemia of the brain usually results from the 
obstruction of one or more of the blood vessels in the brain, and may be 
caused by thrombosis or embolism (page 417). General anaemia is 
caused by hemorrhages ; wasting diseases ; sudden shock ; weak heart 
action; heart disease; or is seen during recovery from severe attacks of 
fever. 

Symptoms. — General anaemia of the brain is marked by great pale- 
ness; fainting; dizziness, which is increased by exercise; headache, less 
painful when lying down; frequent yawning; and occasionally by con- 
vulsions. Partial anaemia is indicated by a loss of power in some special 
muscles in the part of the body which is controlled by the area of the 
brain which is affected. 

Prognosis. — Where the disease is caused by frequent and severe 
hemorrhages, the outlook is not favorable ; if the cause is one which can 
be removed, the recovery is almost certain. 

Treatment. — If general anaemia is the cause, the treatment must be 
along the lines of nourishing food, iron, arsenic, quinine, strychnia, as 
indicated on page 439. On the removal of the cause by such means the 
symptoms will disappear. It is not necessary that the patient pass all 
of the time in bed, but lying down for certain hours during the day will 
be of much relief. If fainting is frequent, follow the treatment as given 
on page 361. The treatment must be directed at the cause, and remedial 
measures advised for such conditions must be followed. For improve- 
ment of the blood these are valuable: — 

Tincture of the Chloride of Iron, 15 drops. 

Dilute Phosphoric Acid, 5 drops. 

Solution of Chloride of Arsenic, 3 drops. 

Lemon Syrup, J^ dram. 

Syrup of Ginger to make 2 drams. 

Take one such dose every six hours in a wineglass of water. 



CONGESTION OF THE BRAIN. 441 

Or:— 

Sulphate of Strychnia, 1 grain. 

Sulphate of Quinine, 48 grains. 

Dilute Hydrochloric Acid, 2 drams. 

Compound Tincture of Gentian, 3 ounces. 

Water, to make 6 ounces. 

Take a teaspoonful in water after each meal. 

CONGESTION OF THE BRAIN. 

An undue fullness of the small blood vessels (capillaries) of the 
brain; often called "rush of blood to the head." It is called active full- 
ness when the arteries are affected ; passive when the veins are filled with 
blood. 

Causes. — Active or arterial fullness is caused by full-bloodedness 
(plethora) ; enlargement of the left ventricle of the heart; excesses in 
eating and drinking; protracted mental labor; acute alcoholism; sun- 
stroke ; tying of a large artery in a surgical operation ; and inhaling amyl 
nitrite. Passive fullness is caused by dilatation of the right side of the 
heart; pressure of accumulations of gas and liquids on veins in several 
parts of the body. 

Symptoms. — These may be sudden or gradual ; they are more marked 
while the patient is lying down. There are headache; neuralgic, dart- 
nig pains; interference with hearing and sight; buzzing in the ears; 
flashes of light before the eyes; dizziness; contraction of the pupils; 
impaired mental powers ; irritability of temper ; red face ; congested eyes ; 
and beating of the large blood vessels in the neck (the carotids) ; dis- 
turbed sleep; and twitching of the limbs. 

Prognosis. — Cases of moderate degree last for a few hours or days 
and pass off; but have a tendency to return. Severe cases are of the 
nature of apoplexy but usually are forerunners of a hemorrhage of the 
brain. 

Treatment. — Elevate the head; apply ice bag or cold cloths to the 
head (page 256) and warm applications to the feet. Leeches may be 
applied to the large process behind the ear (the mastoid) ; dry cups may 
be used on the neck (page 238). In severe cases of an apoplectic nature, 
bloodletting will be beneficial. Good results follow the energetic use of 
purgatives such as : — 

Croton Oil, 3 drops. 

Glycerine, 15 drops. 



442 DISEASES OF ADULTS. 

Give one such dose placed well back on the tongue. 
Or the following enema : — 

Epsom Salts, 2 ounces. 

Glycerine, 1 ounce. 

Boiling Water, 4 ounces. 

Administer as an enema gently (page 234). 

A mustard application to the back of the neck is often useful in mild 
cases. 

DIZZINESS OR VERTIGO. 

A condition in which either the person affected or the objects around 
him seem to be in a state of rapid, circular, rotatory, or backward and 
forward motion. 

Causes. — It may be caused by paralysis of the muscles of the eye, 
by eye-strain or astigmatism ; in which cases it is called ocular vertigo or 
dizziness. Meniere's Disease is the name given to the sudden severe 
dizziness resulting from an affection of the semicircular canals (the coch- 
lea) or the labyrinth in the inner ear. It is the result of a hemorrhage 
or of the escape of pus or other discharges in that disease. Gastric 
Vertigo is the commonest form and is caused by indigestion in the 
stomach or in the intestines, liver trouble or constipation. Nervous 
Vertigo is the result of excesses, the excessive use of tea, coffee, tobacco 
or alcohol, as well as of organic brain diseases. Senile Vertigo, or the 
vertigo of old age, is caused chiefly by anaemia of the brain, as well as 
by changes in the eye in old age (presbyopia). 

Symptoms. — The symptoms common to all forms of vertigo or of 
vertigo from whatever cause are a sensation of objects revolving around 
the sufferer or of the objects remaining stationary and the patient seem- 
ing to move around them ; the attack is sudden ; sight is indistinct ; mind 
is confused; the patient is liable to fall, and grasps at a support; some- 
times vomiting and nausea are present ; but there is no loss of conscious- 
ness, though the patient may fear it. Other symptoms are peculiar to 
the several forms. 

In Ocular Vertigo, which usually follows too close an application 
to reading, sewing, fine work, there are headache; pain in the eyeballs; 
and floating specks before the eyes. 

In Meniere's disease of the ear there are noises in the ear; objects 
move with a variety of motions; there is often a rising and sinking 



DIZZINESS OR VERTIGO. 443 

motion as though the patient were borne on a wave; the sufferer often 
falls by reason of the suddenness of the attack ; moroseness ; irritability 
of temper, and suspicion ; and the attack is usually of long duration. 

In gastric vertigo there are usually the symptoms of indigestion, such 
as flatulency ; heart-burn ; nausea ; pain after eating ; constipation or diar- 
rhoea; and often great pain in the back of the neck. 

In nervous vertigo there is irritability of temper; sleeplessness; head- 
ache; nausea; vomiting; and sometimes symptoms of epilepsy and soft- 
ening of the brain. 

In senile vertigo, dizziness of old age, the attack usually follows exer- 
tion, or even that of sitting erect or standing ; the head swims ; chilliness 
and weakness, with temporary blindness or darkness, are felt. 

Prognosis. — This is favorable in ocular and gastric vertigo ; good in 
nervous vertigo, unless it is organic in its nature; bad in true Meniere's 
disease and in senile vertigo. 

Treatment. — In ocular vertigo, the proper treatment is that given 
by a good oculist, and consists in the application of good fitting lenses 
for the correction of eye trouble of even slight degree. In Meniere's 
disease, the patient must lie down, not necessarily in bed. A 2-grain 
dose of sulphate of quinine every four hours for an extended period is 
advisable. 

In gastric vertigo, attention must be paid to the regulation of the 
diet. See diet for dyspepsia (page 281.) It may be well to start with 
a milk diet exclusively and gradually extend it as improvement takes 
place. It is well in such cases to take : — 

Fowler's Solution of Arsenic, 2 to 3 drops. 

Take in water after each meal. 

When the digestion is slow, 6 to 8 drop doses of nux vomica may be 
taken in water after each meal. 

In cases of constipation : — 

Fluid Extract of Cascara Sagrada, 1 ounce. 

Glycerine, 1 ounce. 

Compound Tincture of Cardamom, y 2 ounce. 

Peppermint Water, y 2 ounce. 

Take a teaspoonful in a wineglassful of water three times a day. 

For nervous vertigo, the cause must be treated. Where it is caused 
by excesses or abuse of narcotics these are easily regulated. For senile 
vertigo the diet must be highly nutritious, and a moderate use of whisky 
may be permitted. 



444 DISEASES OF ADULTS. 

In all forms of vertigo the patient should not use tea, coffee, tobacco, 
malt or alcoholic liquors, except as above stated, or highly seasoned foods. 



ABSCESS. 

A collection of pus or matter which forms a cavity in and among 
tissues and parts which before the attack were entirely closed. It there- 
fore has no communication with the outside until such times as it ripens 
and bursts. In this respect it differs from an ulcer, which is on a free 
surface, and is open from the beginning. It differs from a collection of 
pus or matter in a natural cavity of the body, because that accumulates 
in a cavity which previously existed, and was not made by the breaking 
down of tissues. 

Cause. — The cause of an abscess is inflammation. That state may 
be constitutional and produced by such diseases as consumption, scrofula, 
pyaemia, or other diseases caused by the invasion of contagious microbes ; 
or it may be the result of local causes, such as injury or the presence of 
a foreign body. Sometimes an abscess breaks or points at or very near the 
site of the cause. In other cases it may be far away from it; as in the 
case of Psoas abscess, which appears in the groin, although the exciting 
cause is in the spine. The pus formed in this case burrows among the 
tissues of the muscles and forms an abscess at a considerable distance 
from the starting point. 

Symptoms. — Acute abscesses are attended by inflammaton, redness, 
pain, caused by the pressure upon the nerves; heat, and sometimes by 
hemorrhage when blood vessels have been involved and broken down by 
the progress of the abscess. Chronic abscesses are slow in development 
and are not attended by heat or pain. 

Treatment. — Take a slightly cooling and gentle aperient such as 
Hunyadi Janos water, Epsom or Glauber's salts, or a Seidlitz powder. 

Foment the part with hot flannel, and apply a poultice of linseed 
meal. In parts where the poultice is difficult to retain, it must be put 
in a bag made of muslin with a tape attached to each corner of the bag 
to fasten it on and retain it in its place. The poultice should be renewed 
every six or eight hours. When the abscess looks white in the center, it 
is ripe and should be opened. After discharging pretty freely, a slip of 
lint should be inserted by a probe, and renewed once or twice a day, 
according to the nature of the discharge. After this the part should 
be supported by a bandage, or slips of adhesive soap or plaster, to facili- 



ULCERS. 445 

tate contraction; and the aperture should be left open to facilitate the 
discharge. When healed, tonic medicine and change of air should be 
resorted to. During the continuance of the abscess, the patient should 
live on food which is plain and nutritious, without being stimulating, 
avoiding at the same time, except under extraordinary circumstances, 
wine, spirits, and beer. 

ABSCESS IN THE EAR. 

Apply warm fomentations ; syringe the ear with warm water. When 
the abscess has broken and discharged freely, the ear must be kept clean, 
and a syringeful of slightly astringent lotion, such as ten grains of sul- 
phate of zinc to a quarter of a pint of rose water, should be injected luke- 
warm twice a day. Or this will be found beneficial : When there is 
much discharge, injections of warm soap and water should be used to 
cleanse the ear, and a little fine boric acid blown into it with a quill or 
powder blower. This treatment should be followed twice a day until 
the discharge ceases. 

ULCERS. 

A loss or destruction of the parts on a free surface caused by the 
death of the tissues. 

Cause. — An ulcer may be the result of a wound or bruise, not usually 
a recent one; it may be tuberculosis (or scrofulous), caused by the 
tubercle bacillus; varicose, caused by varicose veins; syphilitic; or the 
result of irritation. 

Symptoms. — They appear on the mucous membranes, such as the 
mouth, tongue, throat, stomach, bowels, etc. ; and on the outer surfaces 
of the body. They present a variety of appearances and are classified 
according to their condition. A healthy ulcer is one which is proceeding 
satisfactorily to a cure, or is healing. It has smooth, unhardened edges, 
a flow of colorless or yellowish thin fluid; red surface; covered with 
painless little growths like grains; and by a formation of skin growing 
over the surface or coming out from the edges. An inflamed ulcer is 
swollen, painful, with puffy edges, painful little grains on the surface, 
and more or less covered with pus or a thick yellow secretion. A slough- 
ing ulcer is inflamed, with rough overhanging edges, and a sloughing 
or eating away of the tissues. A fungous or weak ulcer has pale, flabby 
grains abundantly covering the surface and projecting above it. A 



446 DISEASES OF ADULTS. 

callous or hard ulcer or indolent ulcer has hard, discolored edges, pale, 
and very few grains, and a bad smelling discharge of pus. A cold ulcer 
occurs at the extremities, especially the feet, and is the result of bad 
circulation and nutrition of the parts. A perforating ulcer occurs in 
locomotor ataxia, and is the result of loss of nerve supply. 

Treatment. — In tuberculous and syphilitic ulcers, the treatment is 
constitutional and directed to the cure of the diseases. Others receive 
protective and antiseptic dressings. A good dressing is : — 

Iodoform, i dram. 

Vaseline, i ounce. 

Apply locally. 

Oxide of zinc ointment and aristol are also effective in the dressing 
of ordinary ulcers. Weak and fungous ulcers require stimulation by 
touching the ulcer with nitrate of silver (lunar caustic) in stick form or 
in solution as follows : — 

Nitrate of Silver, 30 grains. 

Water, y 2 ounce. 

This is to be applied to the surface of the ulcer once daily. This is 
effective in ulcers in the mouth and throat, as in putrid sore throat, and 
sore mouth. Another beneficial local application is Black Wash, made 
as follows : — 

Calomel, 1 dram. 

Limewater, 1 pint. 

Apply locally once daily. 

Proud Flesh. — This is a name applied to the red granulations which 
often appear on the surface of wounds and ulcers. If they rise above 
the level of the skin they may be destroyed by a caustic application, such 
as the nitrate of silver or sulphate of copper (blue stone) ; a few grains 
of red precipitate, or a little powdered lump sugar. The first-named of 
the above is the most effectual, but care should be taken in applying it 
only to touch the spots themselves. 

CORNS. 

In the treatment of corns, the first object should be to remove thf\ 
exciting cause; comfortable, well-fitting boots or shoes should be sub- 
stituted for those of an opposite character, and the corn, after the foot 
has been soaked in warm water to soften it, should be pared carefully 



INGROWING NAILS. 447 

away, particular care being taken not to wound the more sensitive part. 
When the outer surface is removed, there will be perceived in the center 
a small white spot, which should be carefully dug out with a pointed 
knife or other sharp instrument. When this, too, is removed, cover the 
seat of the corn with a small circular piece of thick, soft leather spread 
with soap or diachylon plaster, and leaving a small hole in the center, 
corresponding with that from whence the root of the corn has been taken. 
Should any of this latter remain, so as to cause irritation, apply to it, 
every second or third day, a piece of lunar caustic, scraped to a point 
and slightly moistened. Some persons apply strong acetic or other acid ; 
but this is not so effectual, and more likely to cause inflammation, which 
will be best allayed by a warm poultice of bread crumbs, moistened with 
Goulard's extract, the foot being held up as much as possible, and the 
system kept in a cool state with saline aperients, etc. 

Soft corns, which form chiefly between the toes, are often very pain- 
ful and troublesome; let them be cut away as close as possible with a 
pair of scissors, and then dressed with rags wet with Goulard's extract, 
or a solution of sugar of lead ; ivy leaves form, for such, a cool, pleasant 
protection from friction; they should be put on fresh every day. 

Beneath the corner of the nail of the great toe a peculiar kind of corn 
sometimes occurs; it should be cut or scraped out with the finger nail, 
and caustic applied as above directed. Mere callosities of the skin on 
the hands and fingers are not corns, although often called so ; they have 
no roots and are not painful, therefore it is best not to interfere with 
them ; for, if removed, others would come in their places, while the friction 
in which they originate is kept up. 

INGROWING NAILS. 

It often happens that a tight or ill-made shoe, by continual pressure 
on one part of the nail, forces it into the flesh, and thus causes great pain 
and inconvenience. 

Treatment for the Toe. — First procure an easier shoe, which will 
allow the nail to take its natural course ; then take a piece of glass, and 
with it scrape the whole length of the middle of the nail persistently and 
yet with a delicate hand. By this means the center of the nail will 
eventually be rendered so thin that it may be readily bent, and in this 
flexible condition it gives way to the upward pressure of the skin on its 
outward edges, readily bends, and offers no further resistance. The 



448 DISEASES OF ADULTS. 

cause of irritation being withdrawn, the tenderness soon heals, and the 
proud flesh drops down. 

An ingrowing nail may be caused by an improper mode of cutting it. 
Nails should never be clipped at the corners, but cut straight across the 
top, if anything, slightly notched in the middle. This leares a sufficient 
amount of resistance at the corners ; for, wear what shoes we may, there 
must always be a certain degree of pressure on the nail, which should be 
provided for. 

Treatment for the Finger. — Wrap the affected finger in a compress 
moistened with a lotion made as follows: — 

Liquor of Ammonia, i ounce. 

Camphorated Alcohol, . . i dram. 

Bay Salt, % ounce. 

Water, J4 pint. 

Mix, and shake well together. After ten minutes, remove this and 
replace it by a compress anointed with camphor pomatum, and kept in 
place till next dressing by a rubber finger-stall drawn over it. Then dis- 
solve one and a quarter ounces of camphor in a gill of brandy, wet a 
narrow band with this solution, place it round the root of the nail, and 
let it remain there until the next dressing. 

The finger nails should be cut of an oval shape, corresponding with 
the form of the finger; they should not be allowed to grow too long, as 
they thereby are rendered more liable to accident ; neither should they be 
.too short, as they thus deprive the ends of the fingers of their protection 
and support. When the nails are naturally ragged or ill-formed, they 
should be gently scraped, afterwards rubbed with lemon, then rinsed with 
water, and well dried with a towel. If the nails grow more to one side 
than the other, they should be cut in such a manner as to make the points 
come as near as possible to the center of the end of the finger. 

CHILBLAINS. 

Chilblains are an inflammatory affection of the skin, generally con- 
fined to the extremities, and especially to the fingers and toes. Exposure 
to sudden alternations of heat and cold usually gives rise to these trouble- 
some visitations, which are rather characterized by itching and irritation 
than pain. Persons of scrofulous habit and languid circulation are most 
subject to them, as children and aged persons. It is a popular fallacy 
that to keep the surface of the skin in a state of unnatural warmth, by 



CHILBLAINS. 449 

hot bottles and woolen socks by night, and fur linings and feet-warmers 
by day, is the best way to prevent chilblains ; but this only serves to keep 
up a constant perspiration, and so weakens the tone of the system and 
increases the liability to them. A nightly footbath of cold or — for aged 
persons — of tepid salt and water, with plenty of friction with a rough 
towel, and exercise during the day, will be most likely to keep chilblains 
from the feet; and for the hands, a careful rubbing so as to get them 
carefully dry after every washing or dipping in water, and an avoidance 
of all unnecessary exposure to severe cold, are the best preventive meas- 
ures. It is a good plan to have a pan of oatmeal always at hand, and 
to rub them well over with that after they have been wetted, and wiped 
as dry as possible. This will absorb any moisture left by the towel, and 
have a softening and cooling effect. Bathing the feet and hands every 
night in warm water in which a small quantity of salt is dissolved is one 
of the best preventives against chilblains. 

Treatment. — Should chilblains come, as sometimes they will in spite 
of all precautions, let them be gently rubbed every night and morning 
with some stimulating application ; alcohol, spirits of turpentine, or cam- 
phorated spirits of wine are all good for this purpose ; but the application 
which we have found most efficacious is a lotion made of alum and sul- 
phate of zinc — two drams of each to half a pint of water, rubbed in 
warm ; it may be made more stimulating by the addition of one ounce of 
camphorated spirits. When the chilblains are broken there must be a 
different course of treatment; the ulcers formed are often difficult to 
heal, especially in weakly and ill-conditioned persons; there is generally 
a great deal of inflammation, which must be subdued by means of bread 
and water poultices applied cold, and afterwards by cooling ointments, 
such as the cerate of acetate of lead, or spermaceti ointment, with forty 
drops of Goulard's extract added to the ounce; should there be a dispo- 
sition to form proud flesh, the ointment of red precipitate should be used. 

On the first symptoms of the appearance or the return of the redness 
or itching, wash the parts with a little warm spirits of rosemary to which 
a few drops of turpentine have been added. If the itching persists it 
can be relieved by a bath of: — 

Alum, 1 ounce. 

Rock Salt, 2 ounces. 

Borax, 2 ounces. 

Powder and mix. Add two teaspoonfuls to a footbath of tepid 
water and soak the feet for fifteen minutes. 



4SO DISEASES OF ADULTS. 

The application of camphor has a most soothing effect. Another 
good lotion is : — 

Glycerine, y 2 ounce. 

Tincture of Iodine, 10 grains. 

Laudanum, 10 grains. 

Mix and shake until thoroughly dissolved. Apply with a camel's- 
hair brush to chilblains that have broken as well as to those which have 
not. 

RASHES. 

Patches of superficial redness of the skin ; they may occur on any 
part of the body, and are generally accompanied by increased heat and 
irritation — sometimes by swelling, inflammation, and considerable pain; 
they are not contagious. 

When red blotches occur in the face they are generally connected with 
some constitutional derangement — often with dyspepsia — to the cure of 
which the general treatment must be directed ; the face should be washed 
in warm water, and the blotches dabbed with camphorated spirits. 

ROSE RASH. 

Rose rash is common with children during dentition, and is there- 
fore called tooth rash. It arises from intestinal irritation, and most 
usually shows itself about the face, although it may appear on any part 
of the body. With adults it usually occurs in hot weather; fatigue, 
drinking largely of cold water, or eating indigestible food, will bring it 
forth. It sometimes occurs during the eruptive form of smallpox, and 
sometimes after vaccination. Mild aperients, such as rhubarb and mag- 
nesia, cooling drinks, tepid baths, with frugal diet and rest, are the best 
remedies. There is usually considerable itching with these rashes, which 
may be allayed by the application of Goulard's extract or some other 
cooling lotion. 

HIVES OR NETTLE RASH. 

This is an eruption of the skin similar to that produced by the sting 
of nettles. It is not dangerous nor contagious. 

Causes. — It is generally thrown out by some particular kind of food 
which disagrees with the system, such as crabs or other shellfish, or 
mackerel ; certain vegetables are likely to produce it, such as mushrooms, 



RASHES. 451 

cucumbers, bitter almonds, or strawberries. Copaiba, cubebs, valerian, 
or the fumes of turpentine inhaled during house painting are also likely 
to occasion nettle rash. 

Symptoms. — The eruption consists of little, solid eminences of irreg- 
ular outline, but generally roundish or oblong, and either white or red, 
or both white and red. It is accompanied with intense heat, and a burn- 
ing or tingling in the affected spots. No part of the body is exempt 
from nettle rash. There are two varieties of this disorder, one of which 
is regarded as acute, the other as chronic, and either persistent or inter- 
mittent. The acute form is usually preceded or attended with feverish- 
ness, and a feeling of general uneasiness, headache, nausea, and vomit- 
ing. In general it appears in the morning, vanishes in the course of a 
few hours, and perhaps reappears again twice or thrice during the day. 
It usually disappears entirely in six or eight days. The chronic form of 
this complaint is intractable and difficult to remove, coming and going 
for a lengthened period, but with little or no feverishness. 

Treatment. — An emetic should be first administered, if the eruption 
is caused by anything recently taken into the stomach; it should be fol- 
lowed by a saline aperient — senna mixture, with salts, is perhaps best, 
and this repeated until the bowels are freely moved ; if the febrile symp- 
toms do not subside, a mixture composed of sweet spirits of niter, two 
drams; liquor of acetate of ammonia, one ounce; and camphor mixture, 
five ounces, should be given, two tablespoonfuls every four hours. In 
the chronic form, a simple diet, active exercise, an avoidance of any 
articles of diet likely to excite the eruption; keeping the bowels regular 
by gentle aperients combined with antacids; a five-grain rhubarb pill 
an hour before dinner, or a small piece of the root chewed, are good reme- 
dial means; the tepid bath should be occasionally used, or sponging, to 
keep the skin in a healthy state ; to allay the irritation, dust starch powder 
over the eruptions, or use a lotion made of rose or elder flower water in 
half a pint of which has been dissolved one dram of carbonate of ammo- 
nia and one-half dram of sugar of lead. 

DISCOLORED SKIN. 

Moles, freckles, and sunburn are some of these affections. 

Freckles are brown spots on the face and hands caused by exposure 
to the sun. Persons affected with these unsightly discolorations may 
remove them, without using cosmetics, by merely stimulating the absorb- 



452 DISEASES OF ADULTS. 

ent vessels of the skin to take them up and carry them away. Any smart 
stimulant will act in this way; but it has been found that the safest are 
taken from the vegetable kingdom. One of the best and easiest is With- 
ering's cosmetic lotion, which is made of a teacupful of soured milk, and 
a small quantity of scraped horse-radish ; let this stand from six to twelve 
hours, then use it to wash the parts affected twice or thrice a day. 

Moles in the skin, or, as they are commonly called, mother-marks, 
are beyond the reach of medical treatment; if they are ever removed, it 
is at the risk of causing a greater disfigurement ; therefore they had better 
be left alone, the more especially as they not infrequently answer a useful 
end — that of positive identification. Large moles which tend to enlarge 
should be removed by the surgeon, as they sometimes develop into can- 
cerous growths. 

DISORDERS OF THE SWEAT GLANDS. 

The proper action of the skin is of the greatest importance to the 
health. Too much or too little perspiration may produce serious conse- 
quences; but can generally be corrected by cold or warm baths, tonics, 
friction, and proper clothing. 

DISORDERS OF THE OIL GLANDS. 

When the skin is not well taken care of, or when a person has very 
sedentary habits, the action of the oil glands becomes sluggish ; the matter 
in the tubes becomes hard and dry and distends them, sometimes raising 
them above the surface, and the ends become black. Again, the oily 
matter is poured out too profusely, so that the skin shines with it; or, at 
times, there may be so little that the skin is harsh and dry. 

Treatment. — For roughness and hardness of the skin, wash with 
soap and water every night, and rub well into the skin an ointment made 
of olive oil, four ounces; carbolic acid, one dram. Take a dose of sul- 
phur and cream tartar twice a week. 

Where the oil tubes have hardened, and formed a horny growth, 
the body should be washed with a quart of water, in which a teaspoonful 
of saleratus is dissolved ; and twice a day use the following ointment : — 

Elder Flower Ointment, i ounce. 

Blue Vitriol, I scruple. 

For blackheads in the skin, wash in strong soapsuds twice a day, and 
rub briskly with a coarse towel, and use the following lotion : — 



PRICKLY HEAT OR LICHEN. 453 

Corrosive Sublimate, 5 grains. 

Cologne, 2 ounces. 

Soft Water, 6 ounces. 

Mix and apply each night and morning. A spare diet will do much 
in some cases toward improving the skin. 



PRICKLY HEAT OR LICHEN. 

This is a disease caused by intense and long-continued heat; but it 
may be excited by the same causes which produce the nettle rash, when 
the system is prepared for it. It is one of the most annoying plagues of 
a tropical climate. 

Symptoms. — The general character of the disease is that of a diffuse 
eruption, with red pimples, and a troublesome sense of tingling or prick- 
ling. There is more or less general irritation, and sometimes a little 
fever at the commencement. 

Treatment. — For the relief of the itching and burning sensation 
attendant on prickly heat, which in tropical countries are often absolutely 
unbearable, the best remedy is cold water — using caution when the patient 
is perspiring. Live sparingly, and take a few doses of a mild purga- 
tive, as the following: — 

Powdered Aloes, . .- 2 drams. 

Powdered Rhubarb, 1 dram. 

Powdered Jalap, 2 drams. 

Powdered Cream of Tartar, 4 drams. 

Magnesia, 1 dram. 

Best Honey, 1 ounce. 

Mix well, and divide into one hundred and twenty pills; take two, 
three, or four on going to bed. 



IRRITATION, ITCHING OR PRURIGO. 

A papulous affection of the skin, accompanied by troublesome itching. 
Sometimes it is attended with a sensation as of ants or other insects 
creeping over and stinging the skin, or of hot needles piercing it. This 
disease, although not dangerous, is a cause of great discomfort, and 
sometimes even misery; it attacks persons of all ages, and is not easily 
got rid of, sometimes lasting for months, and even years. 

Treatment. — Wash well, every evening before going to bed, with 



454 DISEASES OF ADULTS. 

castile soap, and allow it to dry in. Brandy or alcohol may be used in 
the same manner. An ounce of lemon juice in a pint of water, or vinegar 
used in the same proportion, will be found useful ; also, water and spirits 
of camphor. The diet should be carefully regulated, and all stimulants 
avoided. 



ITCH OR SCABIES. 

An animal parasitic disease of the skin, highly contagious and liable 
to affect persons of all ages and stations of life. 

Cause. — It is caused by the itch parasite, acarus or sar copies scabiei. 
It is contracted by contact ; bedding, clothing ; etc 

Symptoms. — The itch mite at once begins burrowing in the skin, 
causing an intolerable itching. In the efforts of the patient to obtain 
relief by scratching, the skin is often broken. The eggs of the insect 
are deposited under the skin in burrows, which are increased in number 
to accommodate the brood as hatched. The itching is worse at night, 
and crusts are likely to form as a result of the severe scratching. Favorite 
sites are the hands, between the fingers, wrists, breasts, and the inside 
of the thighs. The surest identification of the disease is by detection of 
the insect with a magnifying glass. 

Prognosis. — The disease is not self-limited, that is, it will not cure 
itself without treatment. It is not a difficult disease to get rid of by 
proper measures. 

Treatment. — The bedding and clothing of those affected must be 
thoroughly disinfected or sterilized (page 163). The insect is to be first 
killed, then the inflammation excited by its presence is to be allayed. 
Sulphur is the specific in this case : — 

Precipitated Sulphur, 1 dram. 

Vaseline, 1 ounce. 

Apply locally at night. The face and head are not to be treated, 
but the rest of the body is to be covered with this ointment for four suc- 
cessive nights. Proper care must be taken to avoid soiling the bedding. 
The patient may wear old underclothing, socks, and a flannel gown to 
afford this protection. On the fifth day a hot bath is to be taken, the 
clothing changed, and the treatment repeated, if necessary. If the dis- 
ease has not disappeared, a third application is necessary. It may be 
that after the third application only a few isolated sections are left. These 
are to be treated with : — 



ECZEMA. 455 

Carbolic Acid, 5 to 10 grains. 

Vaseline, 1 ounce. 

ECZEMA, HERPES OR TETTER. 

After a slight feverish attack, lasting two or three days, clusters of 
small, transparent pimples, filled sometimes with a colorless, sometimes 
with a brownish lymph, appear on the cheeks or forehead, or on the 
extremities, and at times on the body. 

The pimples are about the size of a pea, and break after a few days, 
when a brown or yellow crust is formed over them, which falls off about 
the tenth day, leaving the skin red and irritable. The eruption is attended 
with heat, itching, tingling, fever, and restlessness, especially at night. 
Ringworm is a curious form of tetter, in which the inflamed patches 
assume the form of a ring. 

Treatment. — The treatment should consist of light diet and gentle 
laxatives. If the patient be advanced in life, and feeble, a tonic will be 
desirable. For a wash use : — ■ 

White Vitriol, 1 dram. 

Rose Water, 3 ounces. 

Mix ; or an ointment made of : — 

Elder Flower Ointment, 1 ounce. 

Oxide of Zinc, 1 dram. 

MOIST ECZEMA. 

This is an eruption of minute, round pimples, about the size of a 
pin's head, filled with colorless fluid, and terminating in scurf. It is 
preceded by languor, faintness, perspiration, and a prickling of the skin. 
Another species of this disease is called sun-heat, which is an eruption 
of a white or brownish color, w T hich generally terminates in yellow scabs. 
It occurs only in summer, and affects those parts which are uncovered. 

In still another species, the eruption is attended with pain, heat, 
itching, intense smarting, and a swelling of the affected part. When 
the blisters break, the water runs out, irritates and inflames the skin. 

Treatment. — Spare diet, cooling drinks, gentle purgatives, and warm 
baths. In old, chronic cases, apply externally either limewater or cor- 
rosive sublimate in a wash proportioned of five grains to one pint of 
soft water. In the last two forms of the affection, apply nitrate of silver 
in solution to the parts. 



456 DISEASES OF ADULTS. 

MILK CRUST ECZEMA. 

This eruption consists at first of slightly elevated pustules or pimples, 
closely congregated, with an inflamed border. These break, and the 
surface becomes red, excoriated, shining, and full of pores, through 
which a thin, unhealthy fluid is poured out, v/hich gradually hardens 
into dark, yellowish-green scabs. When this tetter invades the head or 
scalp, it causes the hair to fall off and is termed a seal!. 

Treatment. — Vapor bath and water dressing. The crusts should 
be removed by a weak lye, made from hard wood ashes or potash ; then 
an ointment should be applied, made of : — 

Mild Nitrate of Mercury Ointment, 3 drams. 

Sugar of Lead, 16 grains. 

Rose Water Ointment, 1 ounce. 

RINGWORM. 

Ringworm is an eruptive disease of the skin — more particularly of 
the head — and of which there are several kinds. 

Causes. — Ringworm has its seat in the roots of the hair, and is 
believed to be attended by the growth of parasitic fungi ; its predisposing 
causes are any derangement of the general health from ill or under 
feeding, breathing impure air, drinking bad water, uncleanly habits, 
scrofula. Its immediate or exciting cause is generally contact with those 
affected with it, or using combs or hair brushes which they have used. 

Wilson remarks that improper food is a frequent predisposing cause, 
and that he has observed it in children fed too exclusively on vegetable 
diet. It is said to occur spontaneously in children ill-fed and uncleanly, 
and it is readily propagated by contagion. It has recently been dis- 
covered that this disease is owing to the presence of a cryptogamic para- 
site, called the trichophyton. 

Symptoms. — The most common kind commences with clusters of 
small, light-yellow pustules, which soon break and form into thin scabs, 
which, if neglected, become thick and hard by accumulation. When 
removed, they appear again in a few days; and by these repetitions the 
incrustations become thicker, and the area of the patches extends, so as, 
if unchecked, to affect the whole head, and extend also to the forehead 
and neck. The patches are of an irregular, circular form. This disease 
occurs generally in children of three or four years and upward. 

Treatment. — The treatment consists in applying to the parts some 



CARBUNCLE. 457 

preparation which will destroy the fungus. The first thing to be done 
is to remove the hair. Afterward the parts should be washed with a 
solution of bichloride of mercury (one part to 250 parts of water), or 
with a solution of sulphurous acid, one part to eight of water. The 
general health should be at the same time attended to, and nutritious 
diet, tonics, cod-liver oil, and regular exercise used when necessary. 

The vesicular form of ringworm is the simplest and most amenable 
to treatment; sometimes it disappears after careful washing and poul- 
ticing, with, perhaps, a few applications of any astringent lotion; but 
the pustular form is far more troublesome and intractable, spreading 
often very rapidly, and running into ulcerous sores, and sometimes reap- 
pearing when it is thought that a cure has been effected. Nothing but 
the greatest care and attention will then eradicate it. Any child afflicted 
with this disease should be separated from other children, on account of 
its contagious nature; wearing each other's caps and bonnets will be 
likely to spread it through a whole school. 

The following will speedily cure this affection : — 

Naphthol, 1 dram. 

Citrine Ointment, 1 dram. 

Thymol, 5 drops. 

Vaseline, 1 ounce. 

Mix and make into an ointment and apply twice a day. 



CARBUNCLE OR ANTHRAX BENIGNA. 

A painful, deep-seated, dark red inflammation of the skin, ending in 
the death of the tissues affected. 

Causes. — The primary cause is a micro-organism; predisposing 
causes are bad health, diabetes, and injury to the part. 

Symptoms. — The first appearance is in the form of an inflamed 
area on the back of the neck, on the shoulder, or between the shoulder 
blades. It is rounded in shape ; and the area soon becomes hard, circular, 
and flat. It varies in size from that of a hazelnut to an orange. The 
color is purplish or violet. After a week or ten days the skin breaks 
and sloughs off, leaving passages for the outlet of pus. Finally the 
entire area assumes the appearance of a large purulent ulcer, with firm 
edges, and the granulations of an ordinary healthy ulcer appear, and 
the part heals, leaving a scar. The growth of the carbuncle throughout 
these stages is attended by heat, pain, and throbbing. 



458 DISEASES OF ADULTS. 

Prognosis. — The outlook is always serious, as blood poisoning is 
more than a possibility at almost any stage. 

Treatment. — The general health must receive attention from the 
beginning of the attack. To this end the diet must be nourishing; stim- 
ulants are required. A valuable tonic for this condition is : — 

Tincture of the Chloride of Iron, 15 drops. 

Solution of the* Chloride of Arsenic, 3 drops. 

Lemon Syrup, y 2 dram. 

Syrup of Ginger, to make 2 drams. 

Take one such dose every six hours. 

Or:— 

Sulphate of Strychnia, 1 grain. 

Sulphate of Quinine, 48 grains. 

Dilute Hydrochloric Acid, 2 drams. 

Compound Tincture of Gentian, 3 ounces. 

Compound Tincture of Cardamom, to make 6 ounces. 

Take a teaspoonful in water after each meal. 

The local treatment consists of the injection of a saturated solution 
of crystals of carbolic acid in every direction throughout the tissue. It is 
very painful for a time, but is very beneficial. Stick caustic potash may 
be used to cauterize the sloughing tissues. When incision is necessary, 
the cuts are made in the form of a cross (crucial incision). When gan- 
grene threatens, the parts must be well treated with antiseptic solutions. 
If septicaemia (blood poisoning) threatens, it is necessary to cut the 
parts out. 

BOIL OR FURUNCULUS. 

An acute affection of the skin marked by the presence of one or more 
superficial abscesses or boils. 

Causes. — The follicles of the hair become impregnated with micro- 
organisms which produce pus. Predisposing causes are poor health; 
anaemia; diabetes; uraemia; friction or injury to the skin; uncleanliness ; 
and contact with certain substances such as tar and petroleum, which act 
as irritants. 

Symptoms. — The boil begins in the sebaceous gland (a sweat gland) 
and never in the tissues. As soon as it has attained a certain size the 
parts affected form a core of dead tissue, and when the boil is mature 
the core comes away with the pus. Although boils occur in numbers 
and in crops as well as singly, they show no tendency to spread. The 



EXCESSIVE PERSPIRATION 459 

abscess begins as a small, round spot, highly inflamed, and of a reddish 
color. It runs its course in about a week, at the end of which time it 
is raised, rounded, pointed, with a yellowish point in the center. This 
yellowish center is called the core; when no core is formed the boil is 
spoken of as "blind." The pain is dull and throbbing; increased on 
pressure, and usually worse at night. Boils in the armpit, and parts 
other than the neck and face, are deeper seated and more painful than 
others. 

Treatment. — Warm applications are required to hasten the forma- 
tion of pus. It is necessary to protect the parts from pressure and fric- 
tion by means of soap plaster and adhesive plaster. 

EXCESSIVE PERSPIRATION OR HYPERIDROSIS. 

A disturbed condition of the sweat glands, marked by an excessive 
secretion of sweat. 

Causes. — The condition has never been satisfactorily explained. 
Disturbance of the sympathetic nervous system often has some connec- 
tion with the affection. 

There are many variations, both in character and degree, of the 
disease. It may be acute or chronic; general or partial; constant or 
intermittent. Local manifestations of it are usually confined to the 
hands, feet, armpits, and genitals. Excessive perspiration of the hands 
is annoying on account of its profuseness ; as often as it is dried, there 
is an immediate flow which interferes with the use of the hands 
in certain occupations, and renders the wearing of gloves impossible. 
Excessive perspiration of the feet is still more annoying and often offen- 
sive. The socks and shoes become bathed with the perspiration which, 
being retained, gives rise to an offensive odor. The feet are rendered 
tender by its presence and the patient becomes foot-sore. When the dis- 
ease affects the armpits and the genitalia, the odor is also often very 
offensive, much more so in males than in females. 

Prognosis. — Cases are often hard to manage, as the conditions per- 
sist in spite of care and attention. When the affection is local, especially 
in the feet, the prognosis is favorable. 

Treatment. — Local treatment is by far the most effectual. Bathe, 
cleanse, and immediately dry the part. One of the best local applications 
is tincture of belladonna applied either diluted or full strength. Astrin- 
gent lotions, such as alum, or tannic acid, made in the proportion of from 



460 DISEASES OF ADULTS. 

i to 8 drams to a pint of water, are also effective. In such cases the 
astringent closes the pores of the skin in the part and cuts off the secre- 
tion. Dusting powders are also beneficial. Among the best of these 
are: — 

Salicylic Acid, 20 grains. 

Oleate of Zinc, 1 ounce. 

To be applied locally. 

Or, after the parts have been washed in a weak solution of carbolic 
acid : — 

Salicylic Acid, y 2 dram. 

Prepared Chalk, 1 ounce. 

Dried Alum, 1 ounce. 

When powdered finely apply with a powder puff. 

On- 
Salicylic Acid, 1 dram. 

Powdered Starch, 3 drams. 

Powdered Soapstone, 3 y 2 ounces. 

This powder is to be sifted into shoes and stockings. 
Frequent change of hose and the drying and airing of shoes are 
necessary in all cases. 

LICE. 

These disgusting vermin most commonly appear when cleanliness is 
neglected, and especially in cases where the body clothing and bed 
clothing are used continuously without change. But there appear to 
be certain habits of body and certain seasons of the year which are favor- 
able to the generation of this kind of vermin, — as, for instance, spring 
and autumn. 

Treatment. — Wash the body well with vinegar and water, and after- 
wards rub in a lotion made as follows : — 

Camphor, grated, y 2 ounce. 

Best White Wine Vinegar, 1 pint. 

Water, 1 pint. 

Mix, and apply night and morning. 

Or take equal parts of garlic and mustard, moisten with vinegar, 
and rub into the skin twice a day. For lice on the scalp, the most effective 
treatment consists in soaking the hair thoroughly, three or four times a 
day, with kerosene oil, and wrapping the head in a cloth for twenty-four 
hours. Then wash the head with green soap and hot water. Apply the 
ointment of ammoniated mercury. In very rare cases it may be necessary 
to repeat this treatment once only. 



SPECIAL DISEASES. 



460* 



DISEASES OF SPECIAL RESEARCH. 



Hookworm Disease (Uncinariasis). The 
parasite, Uncinaria americana, which causes 
this disease, was discovered in 1902. Its 
eggs are deposited in the intestines of the 
human being, but develop after they escape 
from the body. These larvae pass through 
the skin into the blood, which carries them 
through the heart to the lungs, thence to 
the air passages, into the mouth, and on 
through the body. A second method of 
infection is through the mouth either with 
contaminated food or water, or from earth 
containing the larvae. The malady is more 
common in warm, moist localities among 
persons living in unhygienic conditions. 
Physicians in southern Florida estimate that 
90 per cent, of the rural population harbor 
the parasite to a greater or less degree ; 
90 per cent, is the estimate for Porto Rico. 
The skin, waxy-white to dirty yellow in 
color, becomes dry like parchment, and in 
the first stage itches seriously ; a swelling 
of face, ankles, legs, or entire body may be 
present ; anxious, stupid expression of face ; 
prominent abdomen ; finally emaciated ap- 
pearance ; appetite variable but abnormal ; 
nausea frequent ; muscles soft, flabby, and 
weak ; fever usually present. Anaemia is 
the most pronounced symptom. For treat- 
ment thymol, male fern, and, recently, beta- 
naphthol, are used. 

Infantile Paralysis (Anterior poliomye- 
litis). An inflammation of those parts of 
the spinal cord concerned in muscular move- 
ments and development. It begins sud- 
denly and is followed by a paralysis of the 
muscles controlled by the nerve cells at- 
tacked, and may be transmitted to any mem- 
ber of a community it has once invaded. 
It is infectious, frequently epidemic, and 
rages mostly in hot weather. The germ 
passes into the system through the moist 
lining of the nose and mouth. The symp- 
toms are difficult to determine during the 
period of development, which is from one 
to fourteen days after exposure. There is 
usually a slight running at the nose ; the 
pulse is rapid and irregular, often difficult 
to count, and the temperature varies from 
101 to 107 degrees; pains and extreme ten- 
derness in back and limbs, the paralysis of 
which frequently follows in 48 hours. It 
is generally an acute disease, the greatest 
sufferers being children, one to five years 
old, although in 1910 there were many cases 
among persons much older. Data collected 
in Scandinavia indicate that the infection 
can be carried by intermediate persons to 
the healthy from the sick, whether slightly 
or seriously stricken. Massachusetts physi- 
cians have concluded that insects and dust 
aid in spreading the malady. 



Pellagra (Maidismus). In Italy tin- 
cause is attributed to the use of fermented 
maize by the peasantry, the ones mainly 
affected by it. The symptoms are similar 
in both the acute and chronic types. In the 
early stage they are : redness of the skin like 
severe sunburn, inflammation of the mouth 
and stomach, severe dyspepsia, and diar- 
rhoea ; in the more advanced stages intense 
pains in the head and spine occur, mental 
depression follows, and many cases end in 
permanent insanity. It is rapidly fatal in 
the acute, form, death usually ensuing in a 
few weeks or months. The chronic cases 
are milder and, according to Italian scien- 
tists, patients live from twenty to thirty 
years. Pellagra has been known for over 
200 years. In Spain, Portugal, and Cen- 
tral Italy, where it is called "Italian 
leprosy," it is particularly prevalent. The 
people in these localities live largely upon 
maize, which is frequently harvested before 
it is ripe and stored in damp places, where 
it ferments. Whiskey prepared from this 
maize, as well as corn-mush, corn-bread, or 
polenta, may convey the poison. Alcoholism 
is considered by some as a chief cause of 
the disease. Both sexes and all ages are 
subject to it, but the majority of the cases 
occur in later adult life. In 1911 no treat- 
ment had been devised to arrest its progress. 
Sleeping Sickness (Trypanosomiasis). 
It is caused by microscopic wormlike para- 
sites called trypanosomes. The germ is car- 
ried by the tsetse-fly and the disease spreads 
in the rainy season. During the first stage, 
which lasts from two months to a year, 
occasional fever is present, the temperature 
varying from 99 to 102 degrees; a swelling 
of the lymphatic glands is another common 
early symptom ; the second stage shows a 
marked change in the appearance of the 
victim ; the facial expression is heavy and 
dull, all exertion is absent. This condition 
becomes very marked as the malady pro- 
gresses ; walking and all speech are difficult, 
and finally impossible ; during the last week 
the patient is in a state of complete coma. 
Until 1908 the disease was invariably fatal. 
Dr. Paul Ehrlich of Germany sought and dis- 
covered in dyestuffs a specific which he called 
arseno-phenyl-glycin, which cures all ani- 
mals, and is now being successfully tried upon 
human beings. After two injections of small 
doses, a definite cure is effected. This dis- 
ease was first reported in 1803, but nearly 
a century had passed before any attempts 
were made to arrest it. It is confined to 
the equatorial regions of Africa, and affects 
both the white people and negroes. It is 
estimated that in this region within ten 
years fully 400,000 persons had died with it. 



PROGRESS OF MEDICAL SCIENCE 

The oldest medical knowledge, the Egyp- 
tian, is found in the Papyrus Ebers, which 
dates from the sixteenth century B.C. The 
Babylonians had no physicians, but used in- 
cantations against disease. The Hindus were 
proficient in medicine and surgery very 
early ; their influence upon Arabian medical 
knowledge was very great. From the Bible 
and the Talmud we learn of the science 
among the Jews, 1500 B.C. The Vedas, the 



sacred books of India, show that medicine 
was practiced in that country as early as the 
eleventh century B.C. The origin of Chi- 
nese treatment is lost in tradition. Among 
the Greeks and Persians the healing art 
was studied about 500 B.C., when Pythagoras 
explained the philosophy of disease and the 
action of medicine. The Romans learned 
the science at Alexandria, and carried it 
home to Rome. 



SOME NOTABLE EVENTS AND SCIENTISTS. 



Hippocrates, "the father of medicine," 
most celebrated physician of antiquity 
470-357 B.C. 

Difference between arteries and veins 
discovered by Praxagoras 335 B.C. 

Herophilus founded human dissection, 
discovered nerves and lymphatics. .300 B.C. 

Erasistratus distinguished sensory and 
motor nerves, traced their origin and 
and that of veins and arteries. . .280 B.C. 

Electricity for treatment of headache. .. .43 

Galen, the first anatomist, an authority 
on the pulse, author of 83 medical 
works still extant 130-203 

Dioscorides, author of "Dc Materia 
Medica," a work still used by the 
Turks and Moors, lived in the latter 
part of the first or second centuries. 

Smallpox and measles first described by 
Rhazes, an Arabian 850-923 

The first pharmacopoeia by Avicenna, 
author of a famous system of medi- 
cine, The Canon 1 000 

Albucasis wrote on surgery and per- 
formed difficult operations -1106 

First dissection at Strassburg 1517 

Fallopius described the structure of the 
ear; discovered Fallopian tubes. .1523-1562 

Eustachio discovered the thoracic duct, 
the Eustachian tube, and the rudimen- 
tary valve of the heart -1574 

William Harvey explained the circula- 
tion of the blood (1628), which made 
a revolution in physiology 1578-1657 

Capillary circulation, the pigmentary 
layer of the skin, structure of the 
lungs, kidneys, and spleen discovered 
by Marcello Malpighi 1628-1694 

Leewenhoeck discovered the corpuscles 
of the blood, the spermatozoa, and 
bacteria in the mouth ( 1683) ... 1632-1723 

Hoffmann explained influence of the 
nervous system 1660-1742 

First transfusion of blood in man 1667 

Tourniquet used at siege of Besancon. .1674 

Existence of septic poisons proved by 
Albert von Haller 1708-1777 

Inoculation for smallpox introduced 
into England from China 1721 

Surgery made a science by John Hunter 
1728-1793 

Scientific study of insanity ; reformed 
methods for treatment, Binel. .. 1745-1826 

Cures by mesmerism by Frederick A. 
Mesmer 1778 



Edward Jenner completed the discovery 

of vaccination for smallpox 1796 

First use of thermometer in disease. .. 1797 

Diagnosis advocated by Corvisart 1808 

Homeopathy by Samuel Hahnemann. .. 1810 

Stethoscope invented by Lsennec 1816 

Sir Charles Bell discovered that poste- 
rior roots of the spinal nerve cause 

sensation, and anterior, motion 1816 

Chloroform discovered by Guthrie 1831 

First modern germ theory suggested by 

the discovery of the yeast plant 1836 

Theory of contagion advanced by 

Henle 1840 

Hypnotism discovered by James Braid. .1841 
Laughing gas used by Horac^ Wells. .. 1844 
Ether first used by Dr. W. T. G. Mor- 
ton in surgical operations 1846 

Chloroform used as an anaesthetic by 

Sir James Simpson 1847 

Cohn proved that bacteria are plants. . .1853 
Fermentation and putrefaction explained 

by Pasteur 1857 

Virchow supplied the "cellular path- 
ology" 1858 

Laryngoscope perfected by Czermak and 

Turck 1858 

Sir Joseph Lister, founder of "antisep- 
tic surgery" (1861) 1827-1912 

Osteopathy explained by Dr. Still 1874 

Inoculation for hydrophobia by Pasteur 1885 
Theory of germ diseases fully adopted 1885 
Laveran discovered the Plasmodium of 

malaria 1880 

Koch placed tuberculosis among germ 

diseases 1882 

Bacillus of diphtheria discovered by 

Klebs and Loeffler 1883 

Bacillus of tetanus (lockjaw) discovered 

by Nicolaier 1884 

Serum therapy generally adopted 1889 

Dr. Koch discovered lymph for check- 
ing growth of tubercle 'bacillus 1890 

Antitoxin for diphtheria discovered by 

Behring 1892 

X-Rays used in medicine 1895 

Antitoxin for tetanus discovered 1897 

Erysipelas serum used by Marmorek. . . 1902 
Radium used in treatment of cancer. .. 1908 
"606," a remedy for syphilis discovered 

by Dr. Paul Ehrlich 1911 

Vaccination for typhoid fever compul- 
sory in U. S. A 1911 

Spinal meningitis serum discovered by 
Dr. Flexner 1911 



BOOK V. 

WOMANHOOD AND MOTHERHOOD 



MENSTRUATION. 



Menstruation or the monthly flow takes place, generally, between the 
fourteenth and sixteenth years of age, sometimes as early as eleven or 
twelve. A considerable period may elapse between the first and second 
appearance ; but, when it is properly established, its recurrence at regular 
periods may be calculated on with great certainty, unless some functional 
derangement of the system interferes with it. Ordinarily, a lunar month 
of twenty-eight days is the intervening period ; but with some women the 
discharge occurs every third week. The discharge resembles blood in 
color, but it does not coagulate. The quantity is from three to five 
ounces, and the process occupies from three to seven days. 

The cause of this monthly flow is the ripening and expulsion of the 
egg from the ovaries. 

"Omne vivum ex ovo" (Every living thing comes from an egg or 
germ) is the universal law of reproduction. This can be shown as well 
in the vegetable as in the animal kingdom. The oak from the acorn, 
the ear of corn from the grain planted by the farmer, the robin and the 
elephant, all springing from germs, go to prove the truthfulness of this 
law. Every seed, every egg, contains a germ, which, when brought 
under proper influences, will produce its own kind. Thus far all is 
plain enough, but where do these germs originate? It has been ascer- 
tained that each animal, as well as each plant, is provided with an organ 
for the production of these cells or germs. In the female this organ is 
the ovary. The ovaries are two in number — small, oval bodies, about 
one inch in length, a little more than half an inch in breadth, and a third 
of an inch in thickness. Each ovary is attached to an angle of the womb, 
about one inch from its upper portion, by a ligament. The whole physio- 
logical function or duty of the ovary is to mature and deposit its ovum 
or egg every twenty-eighth day, from the age of fifteen to that of forty- 
five, or for about thirty years. This function is suspended only during 
pregnancy and nursing, but sometimes not even then. There are cases 
on record where the woman has had her courses regularly during the 
time she was pregnant, and there are many with whom lactation does not 



4 62 WOMANHOOD AND MOTHERHOOD. 

interfere. During the ripening and discharge of the ovum into the 
canal or tube which conveys it into the womb, the generative organs 
become very much congested, looking almost as if inflamed. This con- 
gestion at last reaches such a height that it overflows, and produces a 
discharge of blood. Menstruation consists merely in the ripening and 
discharge of an ovum which, when not impregnated, is washed away by 
the menstrual blood. It will be seen that a woman can become pregnant 
only at or near the time of her menses. The marvelous regularity of men- 
struation has always excited great wonder. When we look around, we 
see that both animal and vegetable life have regular times at which germ 
production takes place. Fruits and vegetables ripen, and animals produce 
their young, at certain periods. It is a law of nature. Now, since we 
have shown that menstruation consists in the ripening and regular 
deposit of an egg — the flow being but the outward, visible sign of such 
an act — it is possible that a woman may menstruate without any manifes- 
tation. To prove this, there are many cases on record where a woman 
has married and become pregnant without having had the least show, 
which would be impossible if she did not menstruate. Again, a woman 
who has always been regular may have several children, without in the 
meantime having had any sign. This may be explained by her becom- 
ing pregnant during the time she was nursing her first child, carrying it 
to the full term, again becoming pregnant, and so on, until, being no 
longer impregnated, her courses return, and are regular thereafter. 

Menstruation commences at about the age of fourteen or fifteen in 
this country. In warmer climates it appears earlier, and in colder ones 
later.. Menstruation, menses, courses, catamenia, monthly periods, and 
"being unwell," are some of the terms by which this function is desig- 
nated. The appearance of the menses before the fourteenth year is 
regarded as unfortunate, indicating a premature development of the 
organs; while their postponement until after the sixteenth year is gen- 
erally an evidence of weakness, or of some disorder of the generative 
apparatus. If, however, the person has good health, and all her func- 
tions are regular; if her spirits are not clouded, nor her mind dull and 
weak, it should not be considered necessary to interfere to bring them 
on, for irreparable injury may be done. The first appearance of the 
menses is generally preceded by the following symptoms: headache, 
heaviness, languor, pains in the back, loins, and down the thighs, and 
an indisposition to exertion. There is a peculiar dark tint of the coun- 
tenance, particularly under the eyes, and occasionally uneasiness and a 



MENSTRUATION. 463 

sense of constriction in the throat. The perspiration has often a faint, 
sickly odor, and the odor of the breath is peculiar. The breasts are 
enlarged and tender. The appetite is fastidious and capricious, and 
digestion is impaired. These symptoms continue one, two, or three days., 
and subside as the menses appear. The menses continue three, five, or 
seven days, according to the peculiar constitution of the woman. The 
quantity discharged varies in different individuals. Some are obliged 
to make but one change during the period, but they generally average 
from ten to fifteen. 

It is during the menstrual period that the system, especially of young 
persons, is more susceptible to both mental and physical influences. Very 
much depends upon the regular and healthy action of the discharge, for 
to it woman owes her beauty and perfection. Great care should there- 
fore be used to guard against any influences that may tend to derange 
the menses. A sudden suppression is always dangerous ; and among the 
causes which can produce it may be mentioned sudden frights, fits of 
anger, great anxiety, and powerful mental emotions. Excessive exer- 
tions of every kind, long w r alks or rides, especially over rough roads, 
dancing, frequent running up and down stairs, have a tendency not only 
to increase the discharge, but may produce falling of the womb. 

The quantity and duration of the monthly flow varies greatly in dif- 
ferent women, but the regular recurrence of the flow is important to 
health. This should be borne in mind, and due care taken not to suppress 
the discharge by exposure to cold or wet, or by violent exertion of any 
kind about the time when it may be expected. It is desirable that young 
females should be properly informed by their mothers, or those under 
whose care they are placed, of what may be expected at a certain age, 
or they may be alarmed at the first appearance of the menses, taking it to 
be some indication of a dangerous disease or injury, and perhaps, by 
mental agitation, or resort to medicines, do themselves harm. 

DELAYED OR OBSTRUCTED MENSTRUATION OR 
AMENORRHOEA. 

If the menses do not appear at the usual age or for some years after, 
no alarm need be felt, provided there are no constitutional derangements 
which can be attributed to this cause. If the girl has not developed 
about the hips and breast, and feels not the changes peculiar to this period, 
it would be very injurious to attempt to force nature. If, however, she 



464 WOMANHOOD AND MOTHERHOOD. 

is fully developed, and her general health suffers, a course of treatment 
will be necessary. 

Causes. — An undeveloped state of the ovaries or womb ; an impover- 
ished condition of the blood; or the patient may be phthisical (consump- 
tive). 

Symptoms. — Unnatural heats and flushings, headache, tendency to 
faint, and hysterical symptoms are common, also symptoms of anaemia. 
(See "Anaemia.") 

If the patient is consumptive there will be cough, general debility, 
night sweats. (See "Phthisis.") 

Treatment. — If due to imperfect development of the organs of 
generation consult a physician. As a rule, however, but little can be 
done. 

If due to anaemia, treat accordingly. 

If due to phthisis (consumption), treat accordingly. 

If there is no congenital defect of organs of generation, anaemia, or 
phthisis, menstruation will appear in due season. 

Hot vaginal douches may be employed for the purpose of deter- 
mining an increased blood supply to the parts, thereby favoring 
menstruation. 



SUPPRESSED MENSTRUATION OR AMENORRHOEA. 

Suppression is the stoppage of the menses after they have once been 
established. It may be either acute or chronic. 

Causes. — Sudden cold, wet feet during the flow, fear, strong emo- 
tions, anxiety, or any cause that affects the general health. Chronic 
suppression may result from the acute, or from defective nutrition of 
the organs ; from the early termination of menstrual functions, or from 
weakness occasioned by leucorrhcea. 

Symptoms. — The symptoms usually present are those mentioned in 
delayed menstruation, but in a more aggravated form. In chronic sup- 
pression, failure of the general health, loss of appetite, pains in the head, 
back, and side, and constipation are the usual symptoms. At the regu- 
lar periods when the menses ought to appear, there will be great excita- 
bility, and an aggravation of the above symptoms. With those of full 
habit, there will be a strong, bounding pulse, with acute pain in the 
head, back, and limbs ; with the feeble, extreme languor, trembling, shiv- 
ering, and pale visage. 



MENSTRUATION. 465 

Treatment. — A physician should be consulted and his advice fol- 
lowed in every particular. Where the flow has stopped suddenly from 
exposure, the patient may take warm drinks, salient aperients, till the 
bowels are opened; have hot bran poultices applied to the lower part of 
the abdomen; immerse the feet and legs in hot mustard water. The 
patient must be kept as quiet as possible. If the flow fails to appear, 
wait until the next period and use the hip bath a few days before the 
period. To the bath may be added a little mustard; and, on every 
occasion, active friction with dry, coarse towels should be used. Also 
give the following, which seldom fails if persisted in : — 

Barbadoes Aloes, 1 dram. 

Sulphate of Iron, 1 dram. 

Powdered Cayenne, y 2 dram. 

Extract of Gentian, y 2 dram. 

Simple Syrup, Sufficient quantity. 

Mix and make into sixty pills. Dose, one pill night and morning, during 
and between periods, for tonic effect. 

The warm hip bath should be used about the proper period of 
menstruation ; and it would be well to given some uterine stimulant, such 
as a mixture composed of spirits of turpentine, made into an emulsion 
with yolk of an Qgg, and essence of juniper, about six drams of 
the first and one of the last, in a six-ounce mixture, one ounce to be 
taken three times a day. Attempts to promote the discharge in any 
case must not be prolonged much beyond the menstrual periods, between 
which all possible means must be taken to strengthen the system — good 
diet, plenty of active exercise, the use of the shower bath, or cold or 
tepid sponging are proper remedies. 

If the amenorrhcea proceeds from a want of energy in the uterine 
organs, as is often the case after frequent miscarriages, childbearing, 
inflammation, leucorrhcea ("whites"), there will probably be a white 
discharge only, accompanied by acute pain across the flat of the pelvis, 
vertigo, and hysteria. Weakly young women, before the appearance 
of the menses, and elderly ones, at the time of cessation, or "change of 
life," as it is commonly called, are often so affected. In such a case 
aloes, good nutritious diet, and the recumbent position as much as pos- 
sible during the periods. 



466 WOMANHOOD AND MOTHERHOOD. 

PAINFUL MENSTRUATION OR DYSMENORRHOEA. 

This is menstruation preceded, accompanied, or followed by pain. 

Causes. — Neuralgia, abnormal congestion of the generative organs, 
closure of the mouth of the womb, excessive contraction of the mouth 
of the womb, new growths in the womb, displacement of the womb, or 
disease of the ovaries. 

Symptoms. — The pain may be sharp, shooting, and shifting, or there 
is sense of weight, bearing down sensations in the back and flat of the 
pelvis, flashes of heat, a flushed face. Or there may be spasmodic, cramp- 
like or colicky pains, accompanied by the expulsion of membrane from 
the inner surface of the womb, which may be mistaken for blood clot 
or the product of conception, but which if floated in water shows one 
surface smooth, the other rough and shaggy. In all forms the pain is 
usually relieved when the flow becomes full and free. 

Treatment. — Those cases due to obstruction to the outflow of 
menstrual fluids, and those due to ovarian disease, require the services of 
a competent physician. 

Neuralgic cases, and those associated with excessive local conges- 
tion, are benefited by hot water vaginal douches, hot hip baths, hot 
applications externally over the region of the womb, together with the 
use of the following rectal suppository: — 

Extract of Belladonna, i 1 /* grains. 

Cocoa Butter, a sufficient quantity to make three 
rectal suppositories, one of which may be inserted 
every four or five hours, until pain is relieved. 

Should constipation coexist, a purgative dose of Epsom salts ad- 
ministered in a little hot water for quick effect will be of benefit. 

Between periods, take plenty of fresh air and exercise, nutritious foods 
and tonics, such as recommended in the article on "Anaemia." 

Or, one teaspoonful of elixir iron, quinine, and strychnia in a wine- 
glass of water may be taken after each meal. 

PROFUSE MENSTRUATION. 

This appears either as a prolonged or excessive period and is called 
menorrhagia, or as a flow occurring irregularly between the period:^ 
known as metrorrhagia. It may be due to local disease of the womb 
or its appendages, or to disease of the heart, lungs, liver, etc. 

Treatment. — To check the hemorrhage, the following is efficient : — 



MENSTRUATION. 467 

Hydrastin, 6 grains. 

Ergotin, 12 grains. 

Gallic Acid, 36 grains. 

Mix, and divide into twelve capsules and give one every two or 
three hours as required. 

When due to disease of the womb (the most common cause), heart, 
lungs, etc., a physician should be consulted. 

MENOPAUSE OR CESSATION OF MENSTRUATION. 

Cessation gives notice that the period of childbearing is past. With 
females of our age and country, the courses commonly continue up to 
the age of from forty to fifty ; sometimes they cease at about thirty-five, 
and in a few instances they have been known to continue up to the age of 
sixty. This cessation marks what is commonly termed the change of 
life in women, and with those of average health it occasions little or 
no disturbance of the general system. There may be flushings of the 
face, and a sense of fullness in the head, with occasional dizziness, but 
with those who are weak and nervous, or suffering from organic 
disease, we generally see a marked change at this period. With most 
persons the stoppage of the menses is a gradual process — the intervals 
become protracted, the quantity decreases, and by and by disappears; 
with some the cessation is sudden and complete. 

THE WOMB. 

This most important organ is situated in the cavity of the pelvis — 
from whence, when distended in pregnancy, it rises into the abdomen. 
It is of a flattened pear shape, and is held in its place by elastic liga- 
ments. In its natural state it is about three inches in length by two 
in breadth across the broadest part, and one in thickness. At the period 
of puberty it weighs about one and a half ounces; after parturition, 
from two to three ounces; and in the ninth month of utero-gestation, 
from two to four pounds. It is supplied with glands, vessels, and nerves, 
the latter of which constitute an extensive network over its entire 
surface. 

The ovaries are two in number — one on each side of the uterus. They 
are nearly as large as the male testicles, and perform a corresponding 
function. When the egg (or ovum) has been perfected in the ovary, 
it is seized by the extremity of one of the Fallopian tubes, and conducted 
to the uterus. 



468 WOMANHOOD AND MOTHERHOOD. 

FALLING OF THE WOMB (PROLAPSUS UTERI). 

This is the falling of the womb from the weakening of its supports, 
and the pressure of the viscera above, generally increased by tight lacing 
and the pressure of the clothing sustained by the abdomen. Consti- 
pation, and the daily effort to dispel the contents of the rectum and 
straining, aid in the production of this trouble. An abnormally large 
pelvis, pregnancy, and the weight of tumors, abdominal dropsy, violent 
coughing, and the relaxation of the vaginal walls, all tend to produce 
this downward displacement. 

Symptoms.— Severe pain, sometimes hemorrhage and bearing down 
sensations; pain at the back of the head; backache, and aching loins; 
frequent passing of small quantities of urine; constipation; whites 
(leucorrhcea) ; irregular, scanty, or profuse and painful menstruation; 
sterility. 

Treatment. — This can be instituted only by a physician. 

The womb is also liable to fall either backwards (Retroversion) or 
forwards (Anteversion) , but the treatment of these conditions must be 
confided to an experienced physician. 

CANCER OF THE WOMB. 

Symptoms. — Sudden, shooting pain through the abdomen, which 
disappears entirely, or leaves after it a dull aching or gnawing sensation, 
accompanied by discharge of a fluid which is sometimes pale and thin, 
but soon becomes thicker, yellower, perhaps streaked with blood, and 
very offensive, is suggestive of cancer. This pain is gradually rendered 
more severe and almost constant, and an exhausting hemorrhage sets 
in, perhaps continuing until checked by fainting. In other cases, a burn- 
ing heat, followed by a fetid discharge of matter which is mixed with 
streaks or spots of blood, is experienced. 

Treatment, — Cleanliness, fresh air, plain, nutritious diet, regula- 
tion of the bowels, and tranquillity of mind, are all that can be 
recommended in a work like this. The woman who has the misfortune 
to be visited with this affection must resolutely determine to retire from 
the active duties of life, and abstain from indulgences which would 
excite her passions and increase the circulation of blood. Bland, sooth- 
ing nourishment, and local applications, are all that can be administered 
until she can have judicious and experienced medical assistance. Her 
bowels should be kept open; the fetid and erosive discharges should be 



DISEASES OF THE WOMB. 469 

washed away by antiseptic injections as carbolic acid water or creolin — 
one teaspoonful to every quart of warm water. 

POLYPUS OF THE WOMB. 

When a woman has been wasting away for some time with copious 
hemorrhages, and the remedies recommended under the head of "Flood- 
ing" have been faithfully but unsuccessfully tried, there is great reason 
to suppose that she has a polypus, and medical advice should be at once 
procured. Formidable as the last two diseases are, they are not always 
beyond the reach of surgery. An operation is imperative. 

The ovaries, uterus, and Fallopian tubes are so closely connected in 
situation and function that they are generally inflamed together. The 
cause may be weakness, causing a local determination of some general 
disturbance, such as cold or irritation of these organs. It usually fol- 
lows childbirth, abortion, or excessive and violent sexual intercourse. 

ULCERATION OF THE NECK OF THE WOMB. 

Ulceration of the neck of the womb is produced by corroding dis- 
charges and the irritation of continual sexual intercourse. It is readily 
cured by abstinence, vaginal injections, and direct application to the 
parts of a strong solution of nitrate of silver once in five or six days; 
or by the ulcers being touched with solid nitrate of silver once in five 
days. 

FLOODING (UTERINE HEMORRHAGE). 

This commonly occurs after abortion or labor, or it may be occasioned 
by disease of the womb. Immoderate flow of the menses is also called 
flooding, and to this some women are very subject. It is extremely weak- 
ening to the system and therefore should be checked as soon as possible. 

Treatment. — The best treatment is perfect quiet, and astringent 
and tonic medicines like the following : — 

Tincture of Sesquichloride of Iron, 2 drams. 

Infusion of Quassia, 6 drams. 

Mix, and take a tablespoonful every four hours. If there is much 
pain and irritation, add tincture of conium, or hyoscyamus, two drams. 
(See treatment of "Profuse Menstruation.") Should this not have the 
desired effect, consult an experienced physician, as there is reason to 
fear disease of the womb. 



470 WOMANHOOD AND MOTHERHOOD. 

INFLAMMATION OF THE OVARIES (OVARITIS). 

This disease is characterized by pain, heat, swelling, perhaps red- 
ness, in one or both groins. It is to be treated as any other inflamma- 
tion — sitz baths, with rest, and a strict diet. The bowels must be 
occasionally opened by a gentle aperient, as castor oil. Injections of 
tincture of belladonna and hyoscyamus are very useful and soothing. 

INFLAMMATION OF THE WOMB. 

The treatment is much the same, with the addition of local treatment 
of the inner surface of the womb, which must be directed by a physician, 
after thorough examination. 

WHITES (LEUCORRHOEA). 

There is no disease so common among women as this complaint. Few 
married women, particularly if they are mothers, escape its attacks. 
Very generally this troublesome discharge is associated with general 
debility, especially if profuse for any length of time. Hence it is very 
desirable that attention should be paid to it at the commencement; for, 
if neglected, it may seriously impair the constitution. 

Causes. — Over-exertion and irritation of the uterine organs. It may 
also be brought on by diarrhoea, piles, worms, irritation of the bladder 
or of the nervous system, excessive sexual intercourse, miscarriage, 
abortion, and displacement of the womb. Weakness, too, is a cause as 
well as a consequence of this affection; confinement in a warm atmos- 
phere and luxurious living must likewise be numbered among its exciting 
causes. 

Symptoms. — In leucorrhoea the discharge is commonly white and 
thick. After a while the color will perhaps change; sometimes the dis- 
charge will become very acrid, causing abrasion and smarting. In this 
stage it is apt to cause a gleety discharge from the urethra of one hav- 
ing sexual intercourse with the patient. Ere long, if the disease is not 
checked, we get great local irritation and constitutional disturbances : 
there will be costive bowels, pains in the loins and back, great lassitude, 
with nervous and hysterical affections. Menstruation, too, will be irregu- 
lar, at times altogether suspended, and at others profuse. 

Treatment. — If the patient is of full habit, saline aperients should 
be taken, and a spare diet observed; local ablutions should be prac- 
tised three or four times a day, using occasionally a decoction of 



WHITES. 



47* 



poppies for the purpose; the hip bath, and an injection of alum and 
water, with a scruple of powdered opium in each pint, will also be found 
serviceable. The recumbent position should be preserved as much as 
possible, and the parts kept cool. Local treatment will be of little avail 
in cases of long standing unless the general health be attended to. To 
keep the bowels open, take five grains of compound rhubarb pill as often 
as required; and to strengthen and cool the system the following mix- 
ture : — 

Sulphate of Iron, 12 grains. 

Diluted Sulphuric Acid, 1 dram. 

Sulphate of Magnesia, 3 drams. 

Cinnamon Water, 12 ounces. 

Mix, and take two tablespoonfuls two or three times a day. 
Local treatment : — 

Zinc Sulphate, 1 ounce. 

Acetate of Lead, 1 ounce. 

Mix; one teaspoonful in two quarts of warm water as a vaginal 
douche morning and night. 

Or:- 

Borax, 4 ounces. 

Baking Soda, 8 ounces. 

Chlorate of Potash, 4 ounces. 

Mix; two level tablespoonfuls in two quarts of warm water as a 
vaginal douche twice daily. 

Or, mucol, a teaspoonful to a quart of water twice daily as a vaginal 
douche. 

Women who have leucorrhcea should avoid all predisposing causes, 
such as wines and other stimulants, luxurious living, and sensual indul- 
gences of all kinds, especially, and anything which has a tendency to 
enervate and enfeeble the frame. Early rising and regular open-air 
exercise, warm and comfortable clothing, good food and tonic medicine, 
with the use of the shower bath and bathing — these will prove the best 
preventives. 

PRURITIS VULVAE. 

This term designates a condition characterized by excessive irrita- 
tion and itching of the external genitals. It may be due to uncleanli- 
ness, general debility, anaemia, disorders of digestion, diabetes, diseases 
of the uterus, and change of life. Pregnant women frequently suffer 
from it. 



472 WOMANHOOD AND MOTHERHOOD. 

Treatment. — Strict cleanliness, hot water douches, and the parts 
should be bathed with black wash (one dram of calomel to a pint of 
limewater) or baking soda, or borax, one dram to a pint of cold water, or 
the following ointment may be applied : — 

Salicylic Acid, 15 grains. 

Thymol or Ichthyol, 1 y 2 drams. 

Vaseline, 1 ounce. 

Mix, and apply as required. 

If the itching becomes very intense the application of a nitrate of 
silver solution (ten grains to the ounce) may be required. This should 
be used very carefully. The tissues turn dark on application of the last 
solution. 

Alkaline waters are sometimes of benefit, such as alkalithia — a tea- 
spoonful of which may be administered one to three times daily in a 
glass of water half an hour before meals to render the urine bland and 
non-irritating. 

General Tonic Treatment. — Elixir iron, quinine, and strychnine, 
one teaspoonful in a wineglass of water after each meal. 

Or, Phillips' Phospho-Muriate of Quinine, one teaspoonful in a wine- 
glass of water after each meal. 



MOTHERHOOD. 
PREGNANCY. 

Utero-gestation, or the period from the time of conception to that 
of delivery, extends over a space of forty weeks, or two hundred and 
eighty days. In making the necessary provision for the coming of labor, 
it is best to count back three calendar months from the date of the last 
menstruation and add seven days ; for example : if menstruation appeared 
June 16, count back three months to March 16, and add seven days, 
which would make March 23 the probable date of confinement. 

If conception takes place while the woman is nursing, the day of 
delivery can be approximately estimated by the size of the abdomen, but 
this is a very unsatisfactory method. A better plan is to note the appear- 
ance of quickening (foetal movements), which is felt usually about the 
middle of pregnancy (the end of the twentieth week), and count the day 
of delivery to be between twenty and twenty-one weeks later. 

The Signs of Pregnancy. — Three positive signs may be noted at 



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474 WOMANHOOD AND MOTHERHOOD. 

the end of the fourth lunar month or later. They are : ( i ) quickening ; 
(2) hearing the fcetal heart-beat (the listener's ear being applied to the 
woman's abdomen), only a trained ear can detect it; (3) the ability to 
trace the outline of the foetus through the abdominal wall. 

Other signs of pregnancy, termed "doubtful signs," are: — 

1. The Cessation of the Menses. — This is by no means an unfail- 
ing sign, for sometimes this discharge will cease from other causes, and 
sometimes it will continue after conception has taken place. 

2. Morning Sickness. — This generally commences about the fourth 
or fifth week and lasts to about the fourth month. With some this is 
but slight and causes little inconvenience ; but with others it is more con- 
tinuous and serious, sometimes causing the rejection of nearly all food 
for a very considerable period. This symptom, again, cannot be taken 
as a proof of pregnancy; it is merely a suspicious circumstance, to be 
watched in connection with others. 

3. Dyspepsia and Cravings. — The woman's appetite is capricious, 
and she may long for peculiar articles of diet or those out of season. 

4. Enlargement of the Breasts. — They generally increase in size 
about two months after conception. They also become tender and sore ; 
they throb and burn, and, when pressed by the hand, have a hard, knotty 
feeling, in consequence of the swelling of the glands by which the lacteal 
fluid is secreted. The nipple, also, becomes more prominent, and in- 
creases in diameter, while the areola around it assumes a purplish tinge, 
and has on it several little raised pimples of a yellowish white color. 

5. Enlargement of the Womb and Abdomen. — In the fourth month, 
this becomes very perceptible, — the womb, which may now be felt as 
a firm, rounded body, having ascended above the pubes, and pushed the 
bowels up into the abdomen. 

6. Bladder Disturbances. — Urine is voided more frequently owing 
to pressure on the bladder. This condition is relieved after the fourth 
month as the womb rises out of the pelvic cavity into the abdominal 
cavity. It reappears during the last month of pregnancy when the womb 
with its contents sinks into the pelvis. 

7". Changes in the Skin Covering the Abdomen. — There may be a 
slight brownish discoloration of the skin around the navel and extend- 
ing downward, and similar brownish patches may appear on the fore- 
head, face, and neck. These disappear after confinement. Where the 
abdominal skin is stretched, white lines appear and remain after confine- 
ment. 



PREGNANCY. 475 

Conduct During Pregnancy. — A pregnant woman should be aware 
that the advantages obtained by well-regulated habits are by no means 
exclusively conferred on her, but that others equally important are 
likewise conferred on the child, for whom a larger supply of nutrition, 
and of a better quality, will thus be provided; and so its career of life 
will commence strong, vigorous, and less liable to those morbid debilities 
and derangements which affect the children of the indolent, the pam- 
pered, or the debauched. 

From the moment, therefore, that conception has taken place, a new 
and most sacred duty devolves upon the female. She is bound by all 
the ties of maternal sentiment, of humanity, and of moral and religious 
obligations, to protect the being in her womb against every circumstance, 
under her control, which might have an unfavorable influence on its 
delicate organization. 

Diet During Pregnancy. — The peculiar tendency to irritation in 
pregnancy renders it especially proper to avoid undue excitement. 
Moderation and simplicity of food are especially proper in this case. As 
the appetite is frequently very craving during this period, an inordinate 
indulgence in rich and high-seasoned food is among the most common 
errors ; and this mistake is the more readily fallen into from the errone- 
ous idea which many entertain, that, as the foetus draws its nourishment 
from the maternal system, a greater quantity of aliment is required in 
pregnancy. The exercise of caution in the selection of proper food 
appears to be particularly important towards the termination of gestation. 
When the stomach is in a weak and irritable state, oatmeal, the lean 
part of mutton, tender beef, soft-boiled eggs, and stewed apples consti- 
tute appropriate articles of nourishment. But it is always to be recol- 
lected that the temperate use of food is of more consequence than the 
selection. Coffee and tea may be moderately used; but alcoholic drinks 
should be studiously avoided. The temptation to indulge in small potions 
of cordial, or brandy, in the early months of gestation, is often very 
strong; but it ought to be firmly checked, or the deplorable habit of soli- 
tary dram drinking may be the result of indulgence. 

The sensibilities of the stomach, in some instances, undergo extraor- 
dinary derangement, especially in weak and delicate women. Articles 
of food, which, previous to pregnancy, were very grateful and congenial, 
become highly disagreeable, and an almost irresistible craving for sin- 
gular and even disgusting substances is experienced. This remarkable 
irregularity of the appetite is usually called a longing. If the substances 



476 WOMANHOOD AND MOTHERHOOD. 

longed for be not evidently of an injurious character, they should not 
be withheld; in some instances, these longings may be regarded as in- 
stinctive calls of the stomach for articles favorable to the health of the 
individual. Thus, when a strong desire for eating chalk, charcoal, or 
clay is manifested, we are admonished that the digestive powers are 
feeble and that there is a tendency to acidity in the stomach. In such 
cases the means of relief are alkalines, mild laxatives, and tonic vegetable 
bitters. 

Dress and Exercise. — The custom of wearing corsets during gesta- 
tion cannot be too severely censured. It gives rise to functional disorder 
of the stomach and liver, as well as to uterine hemorrhage and abortion 
in the mother; it likewise impedes the regular nourishment of the foetus 
in the womb. The clothing should always be sufficient to protect the 
body against the injurious influence of cold; the abdomen and feet espe- 
cially should be guarded against injury from these causes. In winter, 
or cold and damp seasons, the use of a flannel bandage or roller around 
the abdomen will be found very beneficial and comfortable. All kinds 
of agitating exercise, such as riding in carriages with rapidity over rough 
roads, dancing, lifting or carrying heavy loads, — in short, all masculine 
and fatiguing employment whatever, — ought to be avoided by pregnant 
women; and the more so as gestation approaches the term of its regular 
completion. During the eighth and ninth months of pregnancy unusual 
exertion or fatigue is particularly apt to excite premature labor. Riding 
in an easy carriage on even roads, or moderate walking, may be enjoyed 
with great propriety, and usually with obvious advantage during gesta- 
tion. 

Moral Influences. — Tranquillity and cheerfulness of mind are of 
prime importance during pregnancy. Convulsions, severe hysteria, 
spasms, syncope, hemorrhage, and abortion may be produced by violent 
anger, terror, or jealousy, during pregnancy. Intense grief will occa- 
sion debility, indigestion, jaundice, and various other functional disorders. 
A strong excitement of the imagination is supposed by some to be capable 
of producing impressions on the foetus in the womb. 

The Breasts.— The breasts and nipples should be particularly 
attended to during the latter months of gestation, in order to prepare 
them for suckling the infant. For some weeks before the expected 
termination of gestation, the nipples should be daily washed with luke- 
warm water, then dried by exposing them to the free air, and after- 
wards gently rubbed for five or six minutes with a soft piece of flannel, 



PREGNANCY. 477 

or with the extremities of the fingers. When the skin of the nipples 
is very delicate and sensitive, they may be washed with brandy and 
water, or a wash composed of two drams of the tincture of myrrh, one 
dram of laudanum, and two ounces of water. In using this, the 
nipples should be first bathed with lukewarm water, and dried and 
rut bed as before directed, and then washed with the lotion. Com- 
pression of the breasts by corsets, or any other artificial means, is 
carefully to be avoided. When the nipples are very small, or sunk in 
the breasts, they should be drawn out by means of a suction pump or 
with a common clay tobacco pipe. This process should be repeated 
several times daily, until they have acquired a sufficient degree of 
prominency. 

Care of the Teeth During Pregnancy. — To insure in a child a 
clear mouth full of strong teeth, we should begin with the expectant 
mother. She must bring herself into as perfect a physical condition as 
possible by not violating the laws of nature regarding diet, rest, sleep, 
and fresh air. She must have plenty of fresh air and moderate exer- 
cise, sleep well and long enough; she should chew her food slowly 
and thoroughly, eat a generous mixed diet, not forgetting that baby 
must have bone salts from which to form its bones and teeth, for very 
soon after the beginning of pregnancy there is being created a more 
than normal demand upon the system of the mother for these bone 
forming elements. Now the question arises, "Where must they come 
from?" Noted physiologists, by a careful study of the chemistry of 
the tissues, have presented to science many important data, concerning, 
among other things, the influence of our diet upon the formation of 
various tissues within our bodies, and it is only comparatively recently 
that they have satisfied themselves that in order to supply the wants 
of the system the food must consist of a combination of elements which 
are represented in the tissues, so that for the elements required in the 
baby's system we must look to the diet of the mother. Hence, if we wish 
to harden baby's bones and present it with a good set of teeth, which 
will not be too chalky and brittle and will have the natural elements of 
good tooth structure to resist decay, we must give it a good inheritance 
to such, conditions by incorporating into the mother's food the elements 
of bone formation in some form or other, whether it be in the form of 
medicine or in the articles of food she should take. 

Many cases of deficient nutrition in pregnancy are treated by supply- 
ing the system with the- required elements in a medicinal form, but 



47^ WOMANHOOD AND MOTHERHOOD. 

as nature provides these in abundance in many articles of food, in a 
form far more palatable than medicine and yet far less expensive, we 
can conceive of no need in the average case of anything but good 
judgment in the diet given. 

When we know that an analysis of bone reveals principally the 
phosphate and carbonate of lime, with the chloride of sodium and 
phosphate of magnesia present in small quantities as its inorganic or 
mineral (earthy) matter, and that it is this which we are particularly 
desirous of in the structure of our teeth, we shall then have to assume 
that unless we introduce plenty of these bone forming elements into 
the system of the mother to supply this want, they will be taken from 
the mother's bones — to the harm of the mother. 

As want of space prevents us from noticing the different foods 
which yield the individual salts, it will suffice to say that it is the 
phosphate of lime to which bone owes its firmness and hardness, and 
this salt occurs in combination most abundantly in any of the cereal 
preparations which are made from the whole kernel of wheat, oats, or 
rye; but preeminent among useless, yes, destructive, foods, and that 
for which there is so little compensation for the eating, is common 
white flour, for the gluten, which is the life-giving principle of the 
wheat, is entirely left out of this foolishly fashionable white flour, and 
it is time we were considering the consequences, as it is cruel to feed 
our children upon so imperfect food, for a child deprived of lime 
phosphates in its foods will have rickets, curvature of the spine, and 
loss of teeth; and an adult eating an excess of starch in the form of 
fine white flour has gout, rheumatism, and obesity, with early loss of 
teeth. A person, young or old, subsisting chiefly upon pies and cake 
and other fancy pastry and desserts, as is the case in many well to do 
families that boast of good living, loses his teeth in spite of eternal 
vigilance and most skillful dentistry, but still people scoff at dietary 
reform and blame the dentist and the Creator for their imperfect 
teeth. Why not, then, adopt the wholesome loaf of whole wheat 
bread, which contains four times as much proteid matter as an equal 
weight of white bread, place it upon your tables, and the children will 
soon convince you that it is a wholesome, healthful, natural food, and 
to your own taste all other breads will soon seem flat and unsatisfying? 

We find alkaline, phosphates, and other soluble salts in meat, eggs, 
milk, etc. ; also many articles of the vegetable kingdom might be added 
as a typical diet, to the exclusion of too much pastry cooking. 



TEETH. 479 

And just now a word in regard to the mother's teeth at this period 

It is an old but very true saying that for every child a tooth, and 
many practitioners will be ready to even more than substantiate this 
statement by saying that for some mothers the birth of even one child 
has been the starting point for the loss of nearly all the teeth they have, 
for the disturbances of nutrition during pregnancy often cause an acid 
condition of the mouth and a very highly inflamed condition of the 
mucous membrane, sore and bleeding gums, while at times so very 
painful does this condition become that the thorough cleansing of the 
teeth is made impossible, and the food stuffs remaining around about the 
necks of the teeth undergoing the process of fermentation and acid 
formation, also making a feeding ground for bacteria, which under 
such favorable conditions of heat and moisture grow, thrive, and 
multiply in untold numbers, render in turn a still further acid condition 
by their waste products, producing a most favorable condition in all for 
the destruction of the teeth. 

We have, then, first of all, to prepare the mother's mouth to resist 
these conditions and avoid suffering by a visit to a good dentist, who, 
with a knowledge of the conditions, will with the least possible incon- 
venience to the patient put the teeth into a condition to insure comfort 
for this period. Failure in this measure may result in a great deal of 
suffering, for it is during this time that such disturbances as will 
necessarily arise will be, by the reflex nervous mechanism, referred to 
any diseased tooth along the path of the fifth nerve (which supplies 
the teeth). Oftentimes these conditions give rise to a severe toothache 
for several hours where there are no diseased teeth in the mouth. 

The teeth being in good order, we must now watch the saliva and 
keep it neutral (neither acid nor alkaline in reaction). A convenient 
test for such conditions can be made by the use of litmus paper, which 
can be had in any drug store, made in two colors, red and blue. By 
touching this paper to the tongue when moist with saliva, if it be acid 
the blue paper will be turned red in color; if alkaline, red will be turned 
blue by this test. 

This acid condition may be locally corrected by the use of slightly 
alkaline mouth washes. The one most often recommended by dentists 
is called milk of magnesia (Phillips'), and in case of inflamed gums, 
as referred to above, any good antiseptic mouth wash might be of 
service, among which may be mentioned boro-lyptol, listerine, pasturine, 
and glyco-thymoline ; but where gums are very soft and spongy a more 



4 8o WOMANHOOD AND MOTHERHOOD. 

astringent wash is necessary to harden and shrink the gums, such as the 
following prescription calls for : — 

Tannic Acid, iy 2 drams. 

Iodide Potassium, 12 grains. 

Tincture of Iodine, 1 dram. 

Tincture of Myrrh, 1 dram. 

Rose Water, 6 drams. 

Dissolve the tannic acid and iodide of potassium in the rose water 
and add the tinctures, then strain. 

Use one teaspoonful of this to one-half glass of warm water twice 
daily as a mouth wash. 

Should this wash not relieve the condition it is because its use 
is too superficial to reach the seat of the trouble, which has been of 
so long standing that it will require some prophylactic treatment by a 
dentist, who can render no greater service to humanity in any way 
than in the thorough cleansing of the teeth under the free margins of 
the gum and in such places as the patient cannot reach by the use of 
the tooth brush. And while many have listened to the careful warnings 
of our elders, never to enter the dental office for any dental services 
while in a pregnant condition, a consensus of opinion of best authors 
tells us that in these days, with modern facilities for relief rather than 
for torture, in the hands of a good, careful dentist, it is better for the 
patient's general condition to have dental work of necessity done in a 
temporary way than to suffer the consequences which follow the neglect 
of such services when needed. For to maintain a cheerful attitude, 
which is desired above all, during pregnancy, as there is no tonic 
which will keep up the general tone of the system like peace of mind 
and happiness, would be just as hard to do while under the depressing 
influence of a few growling teeth, as it would be for us to live up to 
all the teachings of the Bible. 

Now, reasoning from a most rational conclusion that as, first, all 
plant and animal life must draw its nourishment from sources contain- 
ing in sufficient quantity their physical constituents, as animals it is 
evident that we develop and subsist solely upon such substances as are 
taken into our bodies. With this fact made clear, it is plain that such 
foods must contain in definite proportions precisely the chemical ele- 
ments of which our bodies are composed, or perfect development is 
impossible. It is also plain and reasonable to suppose that if these laws 
be kept with fairly good judgment, we may expect, under normal 



CONSTIPATION. 481 

conditions, to have a well born, healthy child, fully developed and well 
rounded, with sound tissues and plenty of vitality, — the realization of 
every mother's fondest hopes. 



DISEASES OF PREGNANCY. 

MORNING SICKNESS. 

This complaint is sometimes very troublesome and obstinate. 

Treatment. — The patient should have breakfast in bed, and remain 
in a recumbent position for some time after. Small lumps of ice put 
into the mouth and allowed to dissolve will sometimes give relief. 
Give, if the sickness is troublesome, three times a day, a mixture 
composed of one scruple of bicarbonate of soda, dissolved in a wine- 
glassful of water, to which add a tablespoonful or two of lemon juice. 
Drink while effervescing. 

The following will also be of service: — • 

Bismuth Subnitrate, 80 grains. 

Dilute Hydrocyanic Acid, 16 drops. 

Cinnamon Water, to make 1 ounce. 

Mix, and take a teaspoonful every two hours until nausea and 
vomiting are relieved. 

CONSTIPATION. 

During the latter months of pregnancy constipation is nearly always 
present, the pressure upon the lower bowel being the cause. Violent 
cathartics should not be taken. A moderate dose of castor oil may be 
administered about every other day, or as often as necessary; but if 
the stomach nauseates at repeated doses of this, try the following 
mixture : — 

Sulphate of Magnesia, 1 ounce. 

Infusion of Roses, 6 ounces. 

Cinnamon Water, 2 ounces. 

Dose, a wineglassful every morning early. 
Or:— 

Maltzyme with cascara, or maltine with cascara, may be taken 
on retiring, in one-half to one teaspoonful dosage. 
Or: — 
Sharp and Dohme's Pil Lepactic, one or two pills on retiring. 



4S2 WOMANHOOD AND MOTHERHOOD 

HEARTBURN. 

This may be removed by moving the bowels with a little magnesia, 

and taking a wineglassful of limewater in milk two or three times 
a day; or carbonate of magnesia, ten grains, in cinnamon water, with 
one dram of tincture of gentian; or a tablespoonful of Phillips' milk 
nf magnesia in a like amount of water will frequently relieve this 

condition. 

INCONTINENCE OF URINE. 

The frequent desire to urinate is most frequently due to pressure 
upon the bladder ; sometimes, however, the condition is due to nervous- 
ness. In any event one tablet of cystogen in a glass of water three 
times a day will afford relief. 

Or :— ' 

Formin 160 grains. 

Peppermint Water, ,...,.. 2 ounces. 

Mix. A teaspoonful three times daily in a wineglass of water will 
be beneficial 

Or:— 

Alkalithia 5 one teaspoonful in a glass of water one to three times 
daily one-half hour before meals- 

Owing to the frequent occurrence of diseases of the kidney during 
pregnancy and the serious consequences attending the same, no preg- 
nant woman should neglect to send her physician a sample of morning 
urine once a month for the first seven months, twice during the eighth 
month, and each week during the last month, that he may determine 
the presence or absence of kidney trouble. Nor should she neglect 
to inform her physician should she suffer persistent headache, dis- 
turbances of vision, persistent constipation, puffiness of the face, 
swelling of the feet, scanty flow of urine, or hemorrhage from the 
vaginal tract however slight. 

Shame, or delicacy, should not prevent the woman from disclosing 
to her physician the fact of any past or present local infectious disorder 
of herself or husband Strict attention to these suggestions may save 
her, and her as yet unborn child, serious affliction and even life. 

COUGH AND SHORTNESS OF BREATH 

may occur during the early months of pregnancy, A soothing cough 



MELANCHOLY. 483 

mixture will benefit the cough, but, if it is persistent, the following 
frequently affords relief : — 

Oil of Sandal Wood, 2^ drams. 

Emulsion of Almonds, .... enough to make 4 ounces. 

Mix. One dessert-spoonful three times daily. 

Or:— 

Codeine, . 2 grains. 

Dilute Hydrocyanic Acid, 16 drops. 

Spirits of Chloroform, 3 drams. 

Glycerine, 3 drams. 

Syrup of Wild Cherry, to make 2 ounces. 

Mix. A teaspoonful in water every three or four hours. 

During the latter part of pregnancy, owing to the enlarged uterus 
pressing upward, there may be shortness of breath and cough. Relief 
may be obtained by using above mentioned remedies, but the condition 
usually persists until the womb sinks into the pelvis or until the child 
is born. 

PRURITIS VULVAE OR ITCHING OF THE EXTERNAL 

GENITALS. 

This has already been described in the chapter on "Womanhood" 
(page 471). 

INSOMNIA OR SLEEPLESSNESS. 

A cup of hot malted milk on retiring, a warm bath, or a hot foot- 
bath will frequently induce sleep. If this is not sufficient the follow- 
ing will be of service : — 

Potassium Bromide, 3 drams. 

Fluid Extract of Valerian, 6 drams. 

Simple Elixir, to make 3 ounces. 

Mix. Take a dessert-spoonful in a little water one hour before 
retiring. 

MELANCHOLY, DESPONDENCY, ETC. 

Despondency frequently seizes upon those who are about to become 
mothers; but generally, if the health be pretty good, it is shaken off 
as the great trial approaches. There are some women who are never 
so well and cheerful as during the time of pregnancy, but there are 
many to whom it is indeed a period of trial and suffering; and 



484 WOMANHOOD AND MOTHERHOOD. 

especially is this the case with those who are about to become mothers 
for the first time. If it is apparent that the mental condition is becoming 
serious, treatment should be instituted. 

Treatment. — Keep the bowels open with some simple aperient, such 
as Hunyadi water or Apenta water, administered half an hour before 
breakfast. 

The diet should be light, nutritious, and easily assimilable. 

To quiet the nervous system the combination recommended above 
for insomnia should be given two or three times daily as required. 

A change of environment is advised. The patient should take a 
due amount of exercise in the open air daily, and her surroundings 
should be cheerful. 

VARICOSE VEINS. 

For cramps and pains in the legs, with swelling and varicose veins, 
sponge the legs with cold vinegar and water, and put on roller bandages 
or elastic stockings, and rest in a recumbent position. 

HEMORRHOIDS OR PILES. 

After each movement of the bowels, the parts should be bathed 
with cold water, dried and bathed with witch-hazel, and afterward 
anointed with : — 

Ointment of Nutgall, 1 ounce. 

Ointment of Stramonium, 1 ounce. 

Ointment of Belladonna, 4 drams. 

Mix. Apply locally and insert a little within the anus. 

Or:— 

Iodosyl suppositories, No. 12. Insert one on retiring. 

The bowels should be moved daily by the use of some simple 
aperient, Hunyadi water or Apenta water, half an hour before break- 
fast. 

Or:— 

Pil lepactic, No. 12. One on retiring. 

FALSE PREGNANCY. 

A condition frequently observed about the turn of life. The 
catamenia become irregular, previous to their final cessation, or are 
suppressed for a few periods; at the same time nausea or vomiting 
is experienced, the breasts enlarge, become sensitive or even slightly 



ABORTION. 485 

painful, the abdomen grows fuller and more prominent, distention of 
the intestines by flatus communicates a sensation like that produced by 
the motion of a foetus ; the nervous system is generally much disturbed, 
and the woman feels convinced that she is pregnant, an idea which, 
at the time of life alluded to, is cherished by the sex with an ex- 
traordinary devotion, and relinquished with proportionate reluctance; 
and not infrequently at the end of the supposed gestation, the delusion 
is rendered complete, and almost assumes the character of a reality, 
by the occurrence of periodical pains strongly resembling labor. 

ABORTION OR MISCARRIAGE. 

The premature expulsion of the foetus from the womb, — that is, 
before the seventh month. After that period, if delivery occurs before 
the ninth month, it is called premature labor. 

Causes. — A sudden shock to the system by a fall or a fright ; strain- 
ing, or overreaching; the administration of strong purgatives or 
emetics; sexual indulgence, or aught which may tend to debilitate the 
system; malformation of the generative organs; fevers and severe 
inflammations; syphilis or constitutional disease of any kind; the 
growth of polypi or tumor in the cavity of the uterus, or adhesion 
to the surrounding viscera; and too great contractibility of the uterine 
fibers and blood vessels may cause miscarriage. Frequently a diseased 
condition of the foetus itself causes miscarriage. Two classes of 
females, very different in constitution and appearance, are liable to 
abortion, namely, those of a plethoric habit, and those in a weak and 
irritable condition. Those who continue to suckle after conception has 
again taken place render themselves liable to it, because a certain 
amount of nutriment required by the foetus goes to the formation of 
the lacteal fluid. 

Miscarriage is generally attended with much pain. It weakens the 
system, and often severely tries the constitution of the sufferer, whose 
liability to the accident increases with each occurrence. The periods 
at which it is most likely to take place are said to be about a month 
after conception, again in twelve weeks, and again in the seventh 
month, — the liability increasing in those stages which correspond with 
the periods of menstruation. Some women invariably miscarry at a 
certain stage; and thus, although often in the way to become mothers, 
are never blessed with offspring. 

By this it will be sufficiently plain that pregnant women ought to 



4 86 WOMANHOOD AND MOTHERHOOD. 

avoid all violent exercises of the body, strong mental excitement, over- 
indulgence of sensual appetites, exposure to wet, or any extremes of 
weather, or aught which may tend to constitutional derangement of 
whatever kind; and those who have once aborted should be doubly 
careful on account of their greater liability. 

Symptoms. — These vary considerably, according to the stage of 
pregnancy, but usually there are slight pains in the loins and parts 
about the womb. There is a sense of bearing down, a frequent desire 
to make water or to evacuate the bowels, and a feverish state of the 
system generally. A discharge of blood commonly follows, sometimes 
in clots, at others in gushes; and this will continue until the foetus is 
expelled. As the patient cannot be considered out of danger until 
relieved of the ovum, the discharge ought to be carefully watched, 
and preserved for the examination of the medical man, should he not 
be present during its progress, which is much to be preferred. 

Treatment. — The first object when the premonitory symptoms above 
mentioned set in, is, if possible, to prevent abortion. To this end the 
patient must at once assume a recumbent position, and on no account 
be suffered to move more than may be absolutely necessary. She 
should be covered with clothing sufficient to keep her warm but not 
overheated, and a pillow be placed under the hips. Forty or forty-five 
drops of laudanum in six tablespoonfuls of starch water should be 
injected into the rectum, or a suppository containing one-half grain of 
extract of opium may be inserted into the rectum to quiet the uterine 
contractions. The bowels should be moved gently by such simple 
laxatives as Seidlitz powder, citrate of magnesia, Apenta water, Hun- 
yadi water, castor oil, a glycerine suppository inserted into the bowels, 
or the administration of a simple soap and water injection should the 
opiates cause constipation. If these measures fail the abortion is no 
doubt inevitable and a physician had better be summoned, whose efforts 
will be directed to the relief of pain, prevention of exhaustion, and 
finally the removal of the uterine contents. 

The best preventives of miscarriage are the frequent use of the cold 
hip bath, and sponging the lower part with cold water; strict attention 
to diet, and avoiding all violent purging medicines ; moderate, gentle 
exercise, and entire abstinence from sexual intercourse during the first 
months of pregnancy. 

About abortions voluntarily produced, we can only warn women of 
the folly and danger of resorting to unprincipled empirics, or the use 
of powerful drugs. Death frequently results from the employment 



CONFINEMENT. 487 

of such means as are necessary to produce abortion, and it is far more 
honorable to bear the shame and disgrace of being the mother of 
illegitimate offspring than to incur the risk and sin of destroying your 
own and another life. 

Women in wedlock have positively no excuse for violating the 
parental instinct or wishing to commit so base a crime. 



PREMATURE BIRTH. 

A birth which occurs between the seventh and ninth month of 
pregnancy is called premature. It is a contingency to be most care- 
fully guarded against, for a child born before its regular time can 
scarcely be expected to have the strength and vigor of one which attains 
its full development in the womb. Nevertheless cases have been known 
in which the early-born child has grown up hearty and strong, and 
there are also cases in which, for the mother's sake, a premature labor 
is desirable, as giving the only possible chance of producing living 
offspring at all. Of course, none but a physician should be intrusted 
with the delicate task of bringing about a premature labor, and only 
malformation of the pelvis (deformity), or serious disease of the 
heart or kidneys, justifies the procedure. 



CONFINEMENT OR PARTURITION. 

Few women who are near their confinement are sufficiently cautious 
of exposing themselves to unnecessary fatigue and atmospheric changes. 
Take only gentle exercise, and avoid getting wet, chilled, or heated in 
crowded assemblies. Miscarriages, difficult labors, and frequently last- 
ing injury to mother -and child, if not death of one or both, are not 
infrequently the results of imprudence at this critical period. Therefore 
we impress upon all our readers who are likely to become mothers, the 
duty which they owe to themselves, their friends, and their future off- 
spring, and advise them to refrain from the exciting pleasures and labo- 
rious occupations of life. 

Let all the preparations for the little stranger be made in time, and 
the services of an experienced nurse engaged. Let the mother, or some 
female, be at hand to aid, counsel, cheer, and encourage, not only at the 
actual period of labor, but for some time previously. And let the mother 
in expectancy be treated with all possible love and gentleness. She may 
be fidgety and whimsical, — let her whims be indulged. She is fre- 



488 WOMANHOOD AND MOTHERHOOD. 

quently in a state of great nervous excitement, — let her be soothed and 
dealt with tenderly. 

Preparation of the Bed and Patient. — Cover the mattress with a 
rubber sheet and over this place a cotton or linen sheet, fastening both 
securely with safety pins. A second rubber sheet is then placed across 
the middle of the bed and covered with another cotton or linen sheet. 
On top of these and under the woman's buttocks place a pad (one yard 
square and three inches thick) of cheese cloth or other material padded 
with cotton. This pad receives all discharges. 

When labor is completed this pad, together with the upper rubber 
and cotton sheets, are removed and the patient rests on a dry, clean bed. 

The patient's bowels should be emptied by means of soap and water 
injection or a glycerine suppository, and urine voided before she goes 
to bed. An empty bowel and bladder facilitates labor. When the 
patient goes to bed her nightdress should be rolled up above the small 
of the back to prevent soiling, and the abdomen and thighs be covered 
with a small sheet. 

We will suppose that the inevitable hour has come, and that the 
labor pains are regular, and that delivery proceeds properly, although 
perhaps slowly. If she be a strong, healthy woman, and no unusual 
complications arise to disturb the natural process, but little aid or inter- 
ference may be required. There will be the usual warning symptoms : 
intermitting pains in the back, slight at first, but increasing in intensity. 
There will probably be a slight discharge of mucus, stained with blood, 
and perhaps also a considerable discharge of a clear fluid, popularly 
called "the waters." This is an albuminous liquid filling up the mem- 
brane in which the foetus floats, and so preventing pressure. It some- 
times does not escape until labor has actually commenced by the falling 
down of the child into the pelvis. When this takes place, the recumbent 
position should be assumed. Previous to this, it is best for the patient 
to sit upright or walk gently about, and so assist the action of the uterus. 

When the labor pains become very great, the patient should be placed 
on the bed, previously guarded by some waterproof material, on her left 
side, and not far from the edge, so that needful assistance can be easily 
rendered. She should have a tightly-rolled pillow placed between her 
knees. If there is no unnatural obstruction to the delivery, it is best 
left to nature. Should the patient in the struggle become very faint and 
weak, a little brandy and water may be administered at short intervals, 
but this must be stopped as soon as the labor is over, or inflammatory 
action may ensue. 



CONFINEMENT. 489 

In due time — it may be in two hours, or four, or six, or even, in 
the case of a first child, twenty-four hours — the infant is born, and 
treated according to the directions given in the management of 
infants. 

As soon as the child is born, , and the navel string has been cut and 
tied (see management of newborn, p. 495), a broad bandage or towel 
may be passed around the body of the mother, so as to cover the hips, 
drawn tightly, and pinned or tied, so as to sustain a pressure upon the 
womb, and stimulate the vessels to return to their normal condition. 
Before this is done, however, it will be best to grasp the uterus with 
the hand and with gentle pressure force the removal of the placenta, 
commonly called the afterbirth. 

For a few hours after labor, the patient should be disturbed as little 
as may be. If the pulse is thin and feeble, and the cheeks colorless, put 
a very little brandy and water between her lips now and then; but stop 
instantly if it produces flushing or restlessness ; and do not give it at all 
unless there seems urgent necessity for a stimulant. Soiled bedclothes 
and body linen may be changed as soon as the condition of the patient 
will permit; but all this should be done very carefully and gently to 
prevent fatigue. If the afterpains are severe an anodyne draught may 
be given. It may be composed of from twenty to thirty drops of 
tincture of opium, or one-eighth of a grain of morphine, in an ounce 
of water. 

For eight or more days after labor, the recumbent position should be 
strictly maintained; and the same rule holds good after a miscarriage. 
Some women feel so well and strong in a day or two that they will sit 
up, and sometimes even get out of bed and make themselves useful in 
the house. We have seen a woman at the washtub three days after she 
had been confined; and we have heard of females undergoing the pains 
of labor under a hedge by the roadside, and in a few hours proceeding 
on their journey with their babes at their breasts. But these women 
were semi or entire barbarians; they had not been delicately nurtured. 
With the immense advantages, we must also take some of the disadvan- 
tages of civilization, and those who give birth to children surrounded by 
all its comforts and luxuries, must not attempt to emulate the Indian 
squaw. If they do, they will inevitably suffer for their temerity. Get- 
ting about too early after confinement is, perhaps, the most fruitful of 
all sources of uterine disease. Delicate women, especially, do wrong to 
attempt it, and the strong will be likely to render themselves weak by 
the practice. 



490 WOMANHOOD AND MOTHERHOOD. 

THE BREAST. 

We use this term in its restricted sense, as applied to the glands for 
the secretion of milk. Their full development depends greatly upon 
habit and constitution, being in some much more early prominent than 
in others. In pregnancy their fullest development commences : the 
breast swells, and the nipple enlarges, and by, or near, the time of deliv- 
ery, it is filled with lacteal fluid. Too frequently the proper enlargement 
of the breast is retarded by tight lacing. The consequences are an insuf- 
ficient supply of milk, or a failure of it altogether ; or a nipple so flattened 
and pressed into the breast that it cannot be taken hold of by the mouth 
of the infant. 

INFLAMMATION OF THE BREAST. 

This is a common affection. Various causes may produce it, such 
as a blow, exposure to cold, etc., but the most common cause is infection 
through fissured nipples. When it occurs within the first week after 
delivery, the symptoms are caking of the breast, a lump forming here 
or there in the substance of one or both breasts. The breasts are pain- 
ful and red. The patient experiences a chill or chilliness. There is 
fever, rapid pulse, thirst, and loss of appetite. 

Treatment. — Preventive. The bowels should be moved daily, the 
breasts should be washed before and after nursing with a boric acid 
solution (one teaspoonful to a pint of water). 

If fissures develop, a breast shield should be used and the fissures 
treated with compound tincture of benzoin applied with a camel's-hair 
brush to the fissure only. Or, they may be covered with subnitrate of 
bismuth and castor oil, equal parts. 

Compression of the breasts by bandage, a brisk purgative, such as 
Epsom salts. On this treatment the condition frequently subsides within 
twenty-four or thirty-six hours. Should it persist, as it frequently does 
in those cases which commence during the third or fourth week after 
delivery, the symptoms already enumerated become more marked, and 
the caked portion of the breast becomes soft and fluctuating. Pain is 
constant and of a throbbing character. If suppuration takes place, 
we have to deal with abscess of the breast and treatment is surgical. 

The child must not be allowed to nurse an inflamed breast. The milk 
may be withdrawn by means of a breast pump, the breast kept at rest 
by means of a tight fitting bandage. The breast may be smeared with 
ointment of belladonna applied once daily and stroked toward the nipple, 



.MILK FEVER. 491 

Or, lint kept wet with lead and opium wash may be applied. 

Internally a brisk purge with Epsom salts repeated daily to lessen the 
formation of milk, and the following capsule to reduce fever and lessen 
inflammation : — 

Quinine Sulphate, 30 grains. 

Powdered Opium, i l / 2 grains. 

Extract of Aconite Root, 2 grains. 

Mix; and divide into six capsules. Take one every three hours. 
If suppuration takes place, the treatment is surgical. 



SORE NIPPLES. 

These frequently occur after childbirth. Xipple shields may be 
readily procured, and should be used when the nipples are too sore and 
tender to bear the application of the infant's mouth. 

Equal parts of glycerine and tannin make a good application. It 
should be applied with a camel' s-hair brush, first wiping the part dry 
with a soft piece of linen. 

Or, each fissure may be treated twice daily with silver nitrate. 
twenty grains, dissolved in an ounce of water and applied by means of 
a camers-hair brush (this causes the tissues to turn black). 

These must be washed off before the child nurses. 

MILK FEVER. 

At the onset of lactation, the patient may suffer a slight feverishness. 

Causes. — The cause may be a cold, or any obstruction to the flow 
of milk from the breast. 

Symptoms. — Its first symptoms are increased heat of the system, 
preceded by shivering, and sometimes accompanied with vertigo and 
slight delirium. These are followed by severe headache, thirst, dry 
tongue, quick pulse, throbbing of the temples, and intolerance of light. 

Treatment. — Spare diet, perfect tranquillity, cooling drinks, and 
saline medicines ; the head should be kept somewhat elevated, and bathed 
with cold water or evaporating lotions. If the symptoms should become 
worse in spite of this, apply frequent cooling lotions to the head, and 
put the feet in a warm mustard bath. Most lying-in women have more 
or less of this fever, which is no doubt an effort of Xature to rouse the 
hitherto dormant mammary organs to secrete a proper quantity of 
milk. 



49^ WOMANHOOD AND MOTHERHOOD. 

THE LOCHIA. 

This is a discharge from the uterus, which appears after the birth 
of the child and delivery of the afterbirth, and continues for from two 
to four weeks. For the first week it is blood color, thereafter the color 
gradually disappears until it becomes clear. The napkins applied should 
be perfectly sterile, and changed frequently during the first two or three 
days. 

Should any putrid odor attach to the discharge, the physician should 
be notified at once, and hot water vaginal douches containing a small 
teaspoonful of creolin to the pint should be used three or four times 
daily. If, after the blood has disappeared from the discharge, it should 
reappear, as it frequently does when the woman gets up too soon, she 
should return to bed, use the hot vaginal douches already mentioned, 
and take twenty drops of tincture of chloride of iron, well diluted, three 
times daily. If the blood discharge is very free, fluid extract of ergot, 
thirty drops three times daily, may be taken to arrest the flow. 

AFTERPAINS. 

These seldom appear after the birth of the first child, but following 
subsequent labors, particularly if the womb has not been thoroughly 
emptied of afterbirth and blood clots, they are very severe. 

Treatment. — Immediately after delivery of the child, fluid extract 
of ergot, one-half to one teaspoonful, should be administered to cause 
the uterus to contract and expel its remaining contents. For relief of 
pain, five grains of Dover's powder; or one-eighth grain morphia; or 
two teaspoonfuls of the camphorated tincture of opium (paregoric), 
may be given and repeated every four hours as necessary. 

CONSTIPATION AFTER DELIVERY. 

The bowels should be moved at the end of the second or third day 
by the use of Hunyadi water, Apenta water, Seidlitz powder, or a pill 
containing : — 

Aloin, % grain. 

Belladonna, y% grain. 

Strychnia Sulphate, 1-60 grain. 

Ipecac 1-16 grain. 



DIET AFTER LABOR. 493 

RETENTION OF URINE. 

The urine should be voided some seven or eight hours after delivery. 
If difficulty is experienced in passing urine the woman may rest on her 
hands and knees. Frequently this change of position will enable her to 
urinate freely. Hot applications over the bladder, or sprinkling cold 
water over the region of the bladder, are sometimes efficacious. If these 
do not suffice, the water must be drawn off through a surgically clean 
catheter. 

DIET AFTER LABOR. 

For the first twenty-four hours, tea, coffee, cocoa, milk, water, and 
toasted bread may be allowed; on the second and third days, the fore- 
going liquids, together with soups, beef tea, poached eggs, oysters raw 
or stewed. From the fourth to sixth days, the breast of chicken, baked 
potatoes, junket, wine jelly, malted milk, cereals, may be added to the 
diet already given. 

On and after the sixth day the patient should gradually return to her 
regular diet, avoiding pork, cabbage, turnip, beans, and all fried and 
greasy foods. Her diet should be nutritious and easily digestible. 

PUERPERAL MANIA OR NERVOUSNESS. 

This disease frequently attacks women either a little before, during, 
or shortly after childbirth, and sometimes during nursing. 

Symptoms. — Great nervous irritation; the face is commonly pallid, 
the eye troubled, the tongue white, and skin hot ; the mind wanders and 
conduct is very irregular. 

Treatment. — Give a purge of senna and salts, and keep the bowels 
regular by the compound rhubarb pill. Keep the room darkened and let 
the patient be kept quiet, and free from the interruption of friends. 

Promote sleep by use of bromides (bromide of ammonium, bromide 
of soda, bromide of potash, of each ten grains), administered twice or 
thrice daily as required. If the patient refuses to swallow, suitable treat- 
ment will be injected hypodermically by the attending physician. 

Or, bromide of ammonia, forty-five to sixty grains, together with 
chloral hydrate, fifteen to thirty grains, suspended in milk, may be 
injected into the rectum. 



494 WOMANHOOD AND MOTHERHOOD. 

CHILDBED FEVER OR SEPTICEMIA. 

Causes. — The retention of the afterbirth, either in whole or in part, 
and the decomposition and absorption of it into the circulation. This 
decayed matter added to the blood brings about a condition of blood 
poisoning. 

Symptoms.— It usually appears in from two to four days after con- 
finement. It is almost invariably manifested by a severe chill, or at least 
by a sensation of cold. The temperature rises and may reach 105 degrees 
or 106 degrees, or even higher. The pulse rate follows the rise in tem- 
perature and reaches from 130 to 160 beats a minute. At the onset 
the face is flushed. The patient rarely complains of pain. There is 
very rarely delirium or unconsciousness in the early stages. The dis- 
charges from the vagina have a fetid odor, and usually diminish in 
quantity. Peritonitis may complicate the trouble, in which case there 
is pain in the abdomen, and the temperature does not run so high as in 
the simple cases of blood poisoning. 

Prognosis. — This is one of the most serious complications of child- 
birth. Much depends upon prompt recognition of symptoms and imme- 
diate attention. The prognosis is always grave. 

Treatment. — In all cases of confinement when there is the slightest 
appearance of a chill, immediately notify the physician in charge. The 
same is to be done when a fetid odor attends the discharge. If the 
antiseptic vaginal douche is not sufficient to prevent this sign of decom- 
position, that is evidence of retention of the placenta, or afterbirth, or 
part of it. This matter must be removed at once. There must be no 
blood clots or coagulated blood remaining in the uterus or vagina. A wash 
of two quarts of warm water to which either twenty or thirty drops of 
carbolic acid or from three to four drams of boric acid have been 
added must be used to flush out the parts. This is to be repeated 
once only in from three to four hours. After that, once a day 
is sufficient. No medicine will be of any use so long as any of the 
foreign matter remains in the organ. The bowels must move freely; 
good liquid or semi-liquid food is to be given; and such general symp- 
tomatic treatment as the developments of the case may call for. 




v* 

H 

!* 

5 



BOOK VI. 

CARE, FEEDING, AND DISEASES 
OF CHILDREN. 

J. W. WOODS, M.D. 

Medical College of University of New York ; Sometime Attending Physician Midwifery City of New York ; 
Attending Physician Diseases of Children, Northwestern Hospital. 

Care of the Newborn Child. — After the cord has been tied the child 
is to be placed in a warm blanket in a warm room, while the nurse gives 
attention to the mother. The eyes of the child are to be thoroughly 
cleansed with warm water, or, better, with a solution of boric acid of 
the strength of a teaspoonful of boric acid to one pint of warm water. 
This is best administered with a dropper or glass rod, and the eyes and 
eyelids afterwards wiped dry with a piece of lint. Before bathing, the 
child's body is to be well oiled or anointed with vaseline to soften the 
cheesy substance with which the body is covered. This substance is 
called the vernix caseosa. It is not absolutely necessary to remove all 
of this matter at the first washing, for that sometimes requires more 
violence than is good for the delicate skin of the child. It will come off 
of its own accord in a very short time. The first bath is then to be given 
in water of ioo°. Great care is necessary in handling the child lest it 
fall by reason of the oily coating which it has received. After bathing, 
attention is given to the cord to see that it has not slipped during the 
bath. The mouth is cleansed with tepid water with great care, for the 
parts are very delicate and will not stand any roughness. The cord is 
to be covered with a dusting of powdered boric acid, or 

Salicylic Acid, I dram. 

Powdered Starch, 19 drams. 

This is dusted over the stump of the cord. It is not well to use too 
strong an antiseptic dressing for the cord, as that will prevent the stump 
from falling off as soon as desired. The navel is then covered with a 
piece of lint or dry gauze or absorbent cotton. A strip of flannel of 
about eight or ten inches in width is then passed around the child's body 
loose enough to admit of the easy introduction of a finger under it. 
Before dressing completely it is well to look the child over in examina- 
tion for any injuries received during delivery or for deformities, etc. 
As soon as it is dressed it is to be placed in its crib wrapped in warm 
blankets. Should there be any indication of poor circulation, cold feet, 
or the like, the child should have hot water bottles placed near to it in 



496 CARE OF CHILDREN. 

the crib, but not touching it. The usual precautions about tightness of 
corks, and absence of danger of leakage are to be exercised. 

First Suckling of the Child. — In a few hours after bathing the 
infant may be put to the breast. For the first two days the breasts 
yield a peculiar milk called the colostrum. It is very nourishing and 
mildly laxative. The child should partake of this every four hours. 

The Meconium. — The fecal matter formed in the bowels of infants 
before birth is called meconium. Its timely removal is a matter of no 
small importance. Nature has furnished the appropriate purgative for 
this purpose in the colostrum. The small portion of fluid which the 
child usually receives at the breasts during the first two days possesses 
a decidedly purgative character and generally causes the entire evacua- 
tion of the bowels. Nothing can be more prejudicial to the child's 
health than the almost universal custom of administering some artificial 
purgative to bring about this effect. If the child is permitted to 
suckle before the proper milk is secreted adequate -purgation will follow 
naturally in nine cases out of ten. When, however, the child's bowels 
do not move, give a pinch of brown sugar in a teaspoonful of water, 
or one-half teaspoonful of olive oil, or a small injection of soap and 
water. During the first two days of life the discharge from the 
infant's bowels is black; sometimes tinged with green; but on the 
third or fourth day, when the mother's breasts are secreting true milk, 
they change to yellow. 

Urine. — If the infant does not void urine during the first twenty-four 
hours, sprinkle the region over the bladder with cold water, or give 
the infant a warm bath. If this does not suffice call the attention of 
the physician to the matter at once. It may be that no urine is secreted 
because the child has had too little nourishment, or there may be some 
deformity of the urinary tract. 



DISEASES OF NEWBORN CHILDREN. 
APPARENT DEATH OR ASPHYXIA. 

A pulseless and lifeless appearance of the newborn child. 

Causes. — Interference with the circulation of the blood before or 
during birth; pressure on the cord; or natural weakness and debility 
of the child. 

Symptoms. — If there is only slight asphyxia the child is pale; 
anaemic ; the limbs lifeless ; and the heart beats feebly, If the asphyxia 



ASPHYXIA AT BIRTH. 497 

is more severe and breathing has occurred prematurely, the face is 
purple; eyes, bloodshot; pulse, slow and full; and gasping breathing. 

Prognosis. — If the heart action is audible, however faint, there 
is always hope; there is danger of pneumonia or of brain trouble if 
life is saved. 

Treatment. — In most cases the child begins to breathe and cry as 
soon as it is ushered into the world. This, however, is not always 
the case. Many children manifest no signs of animation when born, 
who may, nevertheless, be re-animated by prompt and judicious man- 
agement. When this state of apparent death depends on lack of 
oxygen, the infant's countenance exhibits a livid or deep red and 
bloated appearance; the eyes are prominent, and the surface of the 
body is warm and reddish. Sometimes the body is flaccid, and the 
navel string has ceased to pulsate. Everything depends on the speedy 
resusciration of the child. When the cord pulsates vigorously, little 
effort is usually required for setting the vital functions again in opera- 
tion. An effort may be necessary to excite the respiratory functions 
by artificial inflation of the lungs and compression of the thorax with 
the hands. In inflating the lungs a silk handkerchief folded double, 
or a fine napkin, should be laid over the mouth of the infant; the 
nurse should then apply her mouth to that of the babe, at the same 
time closing its nostrils, and endeavor by moderate but uniform force 
of insufflation to fill its lungs with air. The covering of the infant's 
mouth is recommended as a means of avoiding rupture of the pulmo- 
nary air cells. 

Some infants remain for a minute or two after birth without any 
or with few efforts to breathe, although they will open their eyes and 
move their extremities with considerable vigor. A few drops of water 
sprinkled on the chest or abdomen will instantly cause them to breathe 
and to cry out lustily. The main point of caution in cases of this kind 
is to avoid tying the cord until its pulsation has ceased or has become 
quite feeble. In all cases where respiration does not ensue immediately 
after birth, or is in any degree embarrassed, prompt attention must be 
given to the removal of the mucus which is usually lodged in the mouth 
and larynx of newborn infants. A swab of absorbent cotton should 
be carefully introduced into the mouth, and the tenacious slime brought 
away. 

Infants are sometimes born in a state of asphyxia. If in such 
cases the cord pulsates it must on no account be divided until pulsation 
has ceased. The mouth should be immediately cleared in the manner 



498 CARE OF CHILDREN. 

just indicated, and a little cold spirits, or cold water, be dashed on the 
pit of the stomach. So long as the cord beats, some stimulant such as 
brandy, spirits of camphor, or ether, may be applied to the lips and 
nostrils. It is also proper to rub the body and extremities gently with 
dry, warm flannels. When the pulsation of the cord has ceased, and 
the child still continues in this state, the cord must be divided and the 
infant wrapped in dry and heated flannel, which is better than the 
warm bath. It is not well to hastily abandon infants in this condition; 
thirty minutes and even a longer period may elapse before the child 
begins to breathe. 

In all cases where resuscitation has been effected from a state of 
asphyxia, it is of the utmost importance to permit the infant to lie 
perfectly at rest for several hours, before it is subjected to the agitation 
and fatigue of washing and dressing. Infants born between the 
seventh and eighth month generally remain in a somnolent condition 
for several weeks, and ought to be as little disturbed by washing and 
dressing as possible. 

Occasionally feeble infants suddenly sink into a condition of syn- 
cope, or apparent death, after everything seems to be going on well. 
This death-like condition usually continues for a few minutes and then 
gradually passes off leaving the infant in a languid and fretful state. 
This affection is probably the result of some intestinal irritation. 
During the paroxysm efforts must be made to re-excite the vital power 
by wrapping the child's body in a piece of thick flannel wrung out of 
hot whisky. A drop of ether, or of spirits of camphor, should be 
applied to the nostrils and lips and weak mustard plasters may be laid 
on the soles of the feet. 

JAUNDICE OF NEWBORN INFANTS. 

A yellow discoloration of the skin which appears within three or 
four days after birth. 

Causes. — Frequently it is the result of too tight application of the 
band around the abdomen. 

Prognosis. — Generally good. 

Treatment. — The mere loosening of the band has often been suffi- 
cient to relieve the condition. Should the condition not then subside, 
one-fourth grain of calomel with a grain or two of white sugar or of 
sugar of milk may be given twice' daily for a day or two. If free purg- 
ing does not follow, this condition must be relieved by the use of castor 



ERYSIPELAS AT BIRTH. 499 

oil. The daily use of the warm bath and gentle friction with the bare 
hand over the region of the liver and stomach will be beneficial, provided 
there is no tenderness of the region or any inflammation. 

INFLAMMATION OF THE BREASTS OF INFANTS. 

An inflammation of the glands of the breasts of children of either sex. 

Causes. — There is a common superstition among nurses that the 
secretion of a few drops of milk in the breasts of newborn infants, both 
male and female, is to be squeezed out for good luck. Others call it 
"witches' milk." Efforts to press this milk out causes a rupture of the 
delicate glands and consequent inflammation. 

Symptoms. — The breasts become red, swollen, and tender. If it 
does not pass away almost at once an abscess forms with the secretion 
of pus. 

Prognosis. — Generally good; but erysipelas often results as a com- 
plication, and this is usually fatal. 

Treatment. — Usually this does not require treatment ; but, if an 
abscess forms, the attention of a doctor will be required. 

ERYSIPELAS OF NEWBORN INFANTS. 

An infectious disease that attacks newborn infants and in no way 
differs from the erysipelas of adults. Also called St. Anthony's Fire 
and The Rose. 

Causes. — The infectious micro-organism which causes the disease 
to appear from two to seven days after birth, circumcision, or injury 
in which the skin is broken. 

Symptoms. — There is high fever; rapid pulse; sometimes convul- 
sions and diarrhoea. The disease begins generally on the lower parts 
of the body as a small, red blotch, and gradually spreads over the 
abdomen and thighs, presenting a swollen, dark red surface. In most 
cases, soon after inflammation is established, vesicles make their appear- 
ance, and the disease soon assumes a dangerous condition, the danger 
of suppuration and gangrene being very great. 

Prognosis. — The earlier the age the less favorable the prognosis. 
Very fatal in infants younger than three weeks. 

Treatment. — The air is to be excluded by local applications of 
cornstarch, cotton wool, collodion, or a five per cent solution of 
ichthyol, or a mixture of ichthyol and vaseline in equal parts. Holt 
recommends a ten to twenty-five per cent ointment of ichthyol spread 



5oo CARE OF CHILDREN. 

upon muslin, applied daily, and covered with gutta-percha tissue to 
prevent drying. Good nursing, nutritious food, and stimulants to keep 
up the pulse are also required. 

LOCKJAW OF THE NEWBORN OR TETANUS. 

An acute, infectious disease marked by paroxysms or spasms. 

Causes. — It is caused by the micro-organism known as the tetanus 
bacillus. This infectious organism usually gains entrance through the 
wound about the navel. 

Symptoms. — Usually the first sign of the disease appears between 
the fifth and tenth days, in the form of stiffness of the jaw and attend- 
ant difficulty in nursing. The child first relaxes and then stiffens and 
remains rigid for a minute or two. This rigidity increases and affects 
the entire body. The body becomes wooden in its stiffness. The 
pulse, breathing, and temperature rise very high. 

Prognosis. — The outlook is very bad. Fatal cases seldom last 
more than forty-eight hours and often only twenty-four. 

Treatment. — This consists chiefly in the use of narcotics and 
anaesthetics to control the spasms. The tetanus antitoxin has proven 
beneficial where it could be given in time. The child must be kept 
quiet without unnecessary moving, bathing, etc. Feeding is best 
conducted through the nasal tube. 

SORE EYES OR OPHTHALMIA OF THE NEWBORN. 

A highly infectious disease of the eyes in newborn children. 

Causes. — A micro-organism contained in some secretion of the 
mother which comes in contact with the infant's eyes during labor. 
Where the child opens its eyes prematurely this danger of infection 
is increased. 

Symptoms. — There is a warning symptom which takes the form 
of a red line drawn around the lids as though done with red ink. If 
this is neglected the disease passes on to the second stage, during which 
the eyelids swell, a thick, purulent matter begins to issue from the 
eyes; the child becomes fretful and uneasy and keeps the eyes per- 
sistently closed. In the third stage the swelling of the lids increases, 
and ulceration of the cornea results. 

Prognosis. — Good so long as the cornea is not involved and abscess 
and perforation do not result. This is the most fruitful cause of 
blindness of children. Nearly one-third of all cases of blindness of 



INFLAMMATION OF THE NAVEL. 501 

children result from this disease. With good nursing and early 
attention the prognosis is favorable. 

Treatment. — The child should be isolated and the doctor called at 
once. If neglected in its early stages, the eye may be permanently 
injured and the sight destroyed. Constant attention must be given 
to washing out the eye with an antiseptic solution. It does not so 
much matter which is chosen so long as the application is made often. 
The following is a good one to use: — 

Boric Acid, 1 heaping teaspoonful. 

Hot Water, 1 pint. 

In applying this use a dropper and inject the solution into both 
sides of the eye and see that the application is made to the entire 
surface of the eye, every twenty minutes, night and day. Once or 
twice a day the eyes are to be treated with a few drops of a fifteen 
to twenty-five per cent solution of argyrol. The next most helpful 
application is cold compresses applied every few minutes by keeping 
fresh compresses on blocks of ice. If only one eye is affected the 
unaffected eye is to be kept covered with an antiseptic applied to a 
cloth, to prevent infection. These cloths may be kept in place over the 
well eye by strips of adhesive plaster. The greatest cleanliness is 
to be observed and cloths are to be destroyed after use in any way 
about the patient. There is also very great danger of the nurse 
becoming infected unless the strictest antiseptic precautions are 
observed. 

INFLAMMATION OF THE NAVEL OR OMPHALITIS. 

Causes. — This condition may be brought about either by bandaging 
too tightly, or may be the result of infection. The tying of the cord 
leaves a wound which is a favorable place for the entrance of germs 
of disease. This condition is aggravated by uncleanliness, the result 
of which is really a sort of blood poisoning. 

Symptoms. — Usually during the second or third week of the 
infant's life there may be noticed redness, swelling, and hardness 
around the navel. This will result in disappearance, abscesses, or 
gangrene according to the promptness and efficacy of treatment or 
the lack of these precautions. Usually the condition terminates in a 
number of small abscesses which may be only on the surface of the 
wall of the abdomen or may be more deeply seated. There may be 
sloughing of the parts, or an eruption similar to that of erysipelas, or 
gangrene of the parts may result. 



502 CARE OF CHILDREN. 

Prognosis. — This is favorable if treated in time. There is danger 
of the inflammation extending to the peritoneum causing peritonitis 
and the danger is then very greatly increased. 

Treatment. — As soon as inflammation of the part is detected, the 
utmost cleanliness must be observed. Wash the parts thoroughly but 
not roughly with a solution of boric acid of the strength of one tea- 
spoonful of boric acid to a pint of water. Then dress the parts with 
aristol, or with equal parts of the nitrate of bismuth and iodoform. 
If there is an appearance of granulations, which are the little grain- 
like growths which attend ulceration, the parts should be touched care- 
fully with a solution of : — 

Nitrate of Silver, ' . 10 grains. 

Water, i ounce. 

The inflammation of the parts surrounding the navel, which some- 
times occurs and resembles the eruption of erysipelas, may be kept in 
check by the use of cloths dipped in the boric acid solution. If 
gangrene forms it may be removed by the application of the peroxide 
of hydrogen. 

The inflammation of the veins and arteries of the navel is a serious 
complication or, really, extension of the inflammation. The prognosis 
in such cases is very bad. 

RUPTURE OF THE NAVEL OR UMBILICAL HERNIA. 

Causes. — This results from the imperfect healing of the wound at 
the navel, and the formation of an opening large enough to permit 
of the protrusion of a part of the bowel. Where this opening does not 
heal well, or when there is a weakness of the wall of the abdomen, 
such conditions as the formation and accumulation of gas in the intes- 
tines, accumulations of masses of fecal matter, continuous crying may 
produce force or pressure enough to cause the bowel to protrude. 

Prognosis. — The majority of cases yield to simple treatment; 
others persist until adult life; but there is always the possibility of 
peritonitis resulting from the strangulation of the bowel. 

Treatment. — Mechanical pressure to keep the bowel in place and to 
<Jose up the opening artificially is the simplest treatment. For this 
purpose a piece of flat cork larger than the opening of the navel is 
laid over the opening after the hernia has been reduced. This cork 
is kept in place by a bandage, or better by strips of adhesive plaster 
around the waist. 



CARE OF DELICATE CHILDREN. 



503 



CARE OF PREMATURELY BORN AND DELICATE 

CHILDREN. 

Premature birth is that which occurs before the full term has 
expired. Delicate children at birth are those which give evidence of 
congenital weakness or of imperfect development. 

Among the indications of such conditions are a weight of less than 
four pounds at birth ; a length of less than nineteen inches ; delicate and 
almost transparent skin; weak cry; breathing weak and irregular; very 
slight and weak movement of the extremities; inability to suckle by 
reason of weakness of the muscles of the mouth; difficulty in swallow- 
ing; and limp condition of the body. 

The treatment of such children aims at securing a proper degree of 
bodily heat, and the taking of sufficient, proper nourishment. One 
method of keeping up the temperature of the body, advocated by Dr. 
Holt, is to oil the body and wrap the child in cotton batting from head to 
foot, leaving only the face exposed. 

The child is then placed in a crib, 
well sheltered from all drafts, and 
well covered. Hot water bottles are 
placed about the child, and the bodily 
temperature taken at frequent inter- 
vals to see that it is not raised too 
high or does not fall too low. In- 
stead of the hot water bags, electric 
heaters may be placed under the 
blanket upon which the child rests. 
These are especially made for com- 
municating warmth, and are attach- 
ed to an ordinary electric light 
holder. The wrapping of cotton 
batting is changed every three days, 
and the child is fed in bed without 
removal. A pad of gauze or absorb- 
ent cotton takes the place of the or- 
dinary napkin. 

The other method of maintain- 
ing the requisite degree of bodily 
heat is by means of the incubator. 

This Is practically a box with glass Fig. 62. Incubator for Care of 

Prematurely Born and Delicate 

Infants. 




504 CARE OF CHILDREN. 

doors; and so arranged that it can be both heated and ventilated. To 
do both of these highly necessary things, one person's time must be 
devoted to watching the child and the incubator. Variations of temper- 
ature are very serious, as are also periods of imperfect ventilation. The 
difficulty of feeding a child without reducing the temperature is not the 
least of the difficulties. So intricate is the proper management that only 
skilled attendants can bring good results, and altogether it can hardly 
be considered practical outside of an institution. 

The feeding of such children is regulated entirely by the size and 
strength of each particular child. Some are able to nurse in a day or 
two; others can be fed with a medicine dropper or similar instrument; 
but a very great many must be fed by force, or by gavage, as that is called. 
This is done with a small funnel and a tube such as a catheter, which 
is put down the child's throat and the food very slowly and carefully 
given to guard against the food returning, or against strangulation. 
During the first day such children as are unable to nurse are given only 
water at the rate of a teaspoonful or two every hour. For children 
of very low weight and imperfect development the only good results 
are obtained from the use of mother's milk. If the mother cannot 
supply this a wet nurse must be procured. Of such milk half an ounce 
is given every hour. At the end of two weeks this amount is to be 
increased to an ounce and the interval lengthened to an hour and a 
half. In three or four weeks the amount is again increased to an 
ounce and a half and the interval lengthened to two hours. In the case 
of a larger and stronger child it is possible that artificial food may be 
taken; modified milk as given on page 522 may be used as there recom- 
mended. 

In all cases immediate attention must be given to the child. 



THE NURSERY. 

This is the room in which the child spends most of his time while 
indoors. In the very great majority of homes it is the living room 
of the family and not a room set apart for the child and its nurse or 
mother. Whatever hygienic or unhygienic conditions prevail in the 
home generally will be met in that room. If they are good, the child 
has a fair start in life; if they are bad, the child of that household 
is terribly handicapped and is not being fairly dealt with. If these 
conditions are not right, the burden of making them so ought not to 
fall upon the mother and housekeeper. It is true that she is the one 



THE NURSERY. 505 

who spends most. of the time in the house and knows these conditions 
better than the father whose business calls him outside all day. But 
there should be united effort to change all that needs change and to see 
that the child receives those healthful surroundings which mean very 
much more to him than the accumulation of a bank account which he 
may never live to enjoy. Beyond all doubt no parent is doing right 
who allows his child to live in rooms which the sunshine does not 
reach during several hours a day, which are not dry, and in whicli 
there is not an abundance of good, fresh air all of the time. 

The temperature of the room should not rise above yo° F. The 
best temperature is 65 F., if that can be uniformly kept; but that 
is ordinarily impossible. Therefore it is better to have it a few degrees 
higher for safety. The only sure guide to the proper adjustment of 
heat is the thermometer, which should be in every home. But look 
out for draughts near the floor. Very often the upper parts of the 
room may be of a comfortable temperature while the air on the floor 
is several degrees lower. To be sure that this is not the case the 
temperature must be taken on the floor as well as at the height at 
which a thermometer usually hangs in a room. 

The furnishings of the room should be as healthful as possible. 
Rugs are better than carpets for the floors. The chairs should be plain 
wood rather than upholstered; the hangings of the windows should be 
simple dark shades that the room may be darkened during the day 
nap; dirt-catching curtains should be removed. The windows should 
be provided with bars for the protection of older children against the 
risk of falling out. The bedstead should be of enameled iron; the 
mattress and pillows of hair, protected by a rubber sheet; and there 
should be no bedclothes or bed hangings that cannot be easily and 
fully washed. 

There should be no plumbing in the room nor should it communicate 
directly with the bath room. Napkins and soiled clothing must not be 
dried in the room. The burning of gas as a night light produces more 
foul air than the breathing of two or three persons. The best nursery 
light is a wax candle. Kerosene lights, if properly adjusted, will not 
give off much odor, but it is difficult to adjust them. 

The air in the nursery should be thoroughly and completely changed 
twice a day. This is best done in the morning after the child has been 
bathed and again towards evening. During this change of air the child 
should be removed to another room. It is also convenient to air the 
room while the child is out of the house. 



506 CARE OF CHILDREN. 

Sleep. — During the first few days of life a child sjeeps a great deal. 
This sleep may be so profound as to cause alarm, but if it is not 
attended by convulsions or rigidity of the muscles there need be no 
concern. If a child is healthy, free from pain, discomfort, or hunger, 
it will sleep during the first four or five weeks from twenty to twenty- 
two hours out of the twenty-four. Towards the latter part of the 
first six months, it sleeps from sixteen to eighteen hours a day, its 
waking intervals being from half an hour to two hours. By the end 
of the first year the sleeping time has been reduced to fourteen hours 
a day, usually made up of eleven or twelve hours at night and two naps 
of from an hour and a half to two hours during the day. At two 
years of age it sleeps about thirteen hours a day including one nap of 
from one to two hours in the day. After the third year the heavy sleep. 
of childhood begins and the child gets from eleven to twelve hours a 
day. After the third year the nap during the day is often skipped 
occasionally and is secured with more ana more effort. 

Much discomfort will be spared both mother and child if right 
methods of sleeping are taught at the start. After the child has been 
fed it should be placed in its crib in a darkened room and allowed 
to go to sleep without rocking, or other incentive. It should never 
be allowed to go to sleep with the nipple in its mouth or with so called 
pacifiers. The use of all such artificial means only encourages the use 
or desire for them and the consequent formation of bad habits. Of 
course the child may cry at first while this education is going on; 
but the mother must remember that the child is not crying from pain 
or from suffering, but if left alone will soon go to sleep of its own 
accord. During the day the child should be wakened from sleep every 
two hours or two hours and a half to be fed. At night it should be 
allowed to sleep for six or seven hours without feeding. This method 
secures not only regularity of feeding but also correct habits of sleep- 
ing. 

Airing. — In fine summer weather the infant may be taken out for 
an airing at the end of the first week. In colder weather this must 
not be done until the child is a month old, and then only when the 
temperature is over 6o° F. The first outing should not exceed fifteen 
or twenty minutes. Each day thereafter the time is to be gradually 
lengthened until the outing lasts from two hours to two and a half 
hours. There must be proper protection of the head against winds, 
and of the eyes against the direct sunlight. It is a good plan to dress 
the child as thougii ready for outdoors, and then to open the windows 



CLOTHING. 507 

of the room on a bright day as a preliminary to going out. A child 
of four or five months may take an outing in winter on fine days 
when the thermometer stands above 20 . But when the wind is high, 
or the snow is melting, or during storms, a child should not go out. 
But on all fit occasions a child should be out of doors as much as 
possible, even sleeping outdoors in preference to indoors in the daytime. 

Exercise. — The first exercise the child gets is through crying. No 
concern need be felt if a child cries for a total of twenty or thirty 
minutes a day. This develops the lungs, and, in fact, does much 
towards the development of the muscles. Then comes the kicking and 
play of the limbs while lying in bed or on the mother's lap. This 
and the resistance against the hand placed at the feet are genuine forms 
of exercise. To facilitate this there should always be free play to the 
child's limbs. It is wrong to so clothe the child that these movements 
are impeded. Carrying the child about, frequently changing its posi- 
tion, and rubbing its back and limbs are also beneficial forms of exer- 
cise. This applies to children who are too young to creep or stand. 
When that activity begins the child should have every possible means 
of indulging it. A mattress or thick rug should be placed on the 
floor upon which the child may roll or kick at will. Later in life the 
child will begin those helpful and beneficial forms of games which 
will supply all that is needed. 

Clothing. — There are only a few fundamental principles to be 
observed in the clothing of children. The clothing must not be tight- 
fitting. The free play of the limbs must not be interfered with, nor 
must the binder be so tight as to compress the abdomen or chest. The 
latter must always be so loose as to easily permit the finger to be 
inserted between it and the body. Next, all parts of the body covered 
by the clothing must be as uniformly protected as possible. The only 
exception to this may be in protecting parts of the trunk rather more 
than the extremities. But there is no possible justification for bare 
legs in cold weather. The clothing must be of such material as to keep 
in the warmth of the body in cold weather and to keep out the heat of 
the sun in warm weather. It must also be comfortable and agreeable 
to the skin. The objection to all-wool is its great liability to shrink. 
This is overcome to some extent by the use of merino, or a fleece-lined 
cotton. Next to the body of children of all ages should come the 
woolen shirt, which should be both high in the neck and full length in 
the sleeves. The band is worn under this by young infants for the 
first month; after that it is of rather doubtful value. If the child 



508 CARE OF CHILDREN. 

is thin and delicate so that the walls of the abdomen are not so strong 
as is desired, it may be continued, but must never be drawn tight, in 
spite of its name. In summer the shirt is to be of fine flannel, very 
thin, or of gauze. The napkins, or diapers, are to be of absorbent 
material, preferably stockinet or Canton flannel. Under no conditions 
should rubber or waterproof material be used for this purpose. The 
feet must be kept warm, if necessary a hot water bottle is to be used 
in the bed at night. Cold is too frequently the cause of colic and of 
indigestion. The night clothing of the child must be warm, but not 
burdensome. Where children will not keep the covers over them at 
night, a garment with feet may be used of a weight adapted to the 
season of the year. Where children have too much night clothing 
they are usually restless. 

Bathing. — For the first six months the temperature of the bath 
should be at the normal temperature of the body, — about 98 . The 
room should be warm and the duration of the bath not more than ten 
minutes. There should not be very vigorous rubbing at this age. 
The soap should be of the best quality of castile and it is to be 
used very sparingly at first. After six months the temperature may be 
reduced to 95 ° ; and at the end of the first year to 90 . At an older 
stage the bath may be concluded with a cold sponge followed by 
vigorous rubbing. But many children do not react from the cold bath 
and show the effects by dark rings around the eyes, and a shadow 
around the mouth. When these signs appear the cold bath must be 
discontinued. The best time to give the warm bath is in the evening, 
and the cold sponge in the morning. There is no risk in fine weather 
of a child going out in an hour or so after the warm bath, and at once 
after a cold sponge bath. 

Growth and Development. — Observation of growth and develop- 
ment is necessary to ascertain whether or not the child is advancing 
properly, whether or not the food that he is getting is properly nourish- 
ing, and whether he is in a state of health. One of the easiest ways to 
judge of his development is by 

Weight. — An infant should be weighed regularly during the first 
two years of life. This should be done in the case of healthy children 
every two weeks ; in the case of delicate children more frequently. Scales 
especially designed for this purpose are fitted with a basket in which 
the child can be conveniently placed to be weighed. Care should be 
taken that the child is weighed at about the same time after feeding and 
stool on each occasion, as these considerations materially affect the weight. 



WEIGHT. 



509 



The average weight at birth is about seven and one-third pounds. Dur- 
ing the first two or three days after birth there is a loss of from one-half 
to one pound. This is partly due to the removal of matter from the 
intestines and the fact that the mother's milk contains no nourishment 
for the first two or three days. At the end of the tenth day the child 
has regained the lost weight and is again at the weight at birth. The 
weekly weighings of the child should be registered upon a weight chart. 
This will show the gain or loss, and is of immense value in cases of 
artificial feeding and in regulating diet for delicate children. If the lost 
weight of the first three 
days is not made up dur- 
ing the next succeeding 
week, there is every indi- 
cation that the mother's 
milk is not nourishing 
and that artificial feeding 
must be resorted to. 
Where children are fed 
naturally there is a steady 
gain in weight after the 
tenth day. But if a child 
is fed artificially at that 
period there is usually a 
stationary period of about 
two weeks during which 
the child is adapting him- 
self to the new con- 
ditions. After that the gain is steady if the food is agreeing 
with him. The child gains most during the first three months of 
his first year. From the six to the ninth month it is least. A child of 
average weight at birth ought to weigh three times that weight at the 
end of the first year, that is, about twenty pounds. He gains about a 
quarter of a pound a week during the first six months and a little less 
each week during the last six. If a child does not gain steadily, not 
necessarily in just such proportions, there is something wrong, and the 
conditions should be carefully investigated. The increase in weight dur- 
ing the second year is about six pounds; and in the third year between 
four and five pounds. 

Height. — The average height at birth is about twenty and one-half 
inches. During the first year a child gains a little over eight inches; 




Fig. 63. Scales for Weighing a Child regularly. 



5io 



CARE OF CHILDREN. 



TABLE 

Showing Growth and Development in Boys and Girls from 

Birth to Ten Years. 







Weight 


Height 


Chest 


Head 


Age 


Sex 










Pounds 


Inches 


Inches 


Inches 


Birth 


Boys 


7-55 


20.6 


13-4 


13-9 




Girls 


7.16 


20.5 


13.0 


*3-5 


6 mos. 


Boys 


16.0 


25-4 


16.5 


17.0 




Girls 


15-5 


25.0 


16. 1 


16.6 


12 mos. 


Boys 


20.5 


29.0 


18.0 


18.0 




Girls 


19.8 


28.7 


17.4 


17.6 


1 8 mos. 


Boys 


22.8 


30.0 


18.5 


18.5 




Girls 


22.0 


29.7 


18.0 


18.0 


2 years 


Boys 


26.5 


32.5 


19.0 


18.9 




Girls 


25-5 


32.5 


18.5 


18.6 


3 years 


Boys 


31.2 


35-o 


20. 1 


19-3 




Girls 


30.0 


35-o 


19.8 


19.0 


4 years 


Boys 


35-o 


38.0 


20.7 


19.7 




Girls 


34-o 


38.0 


20.5 


19-5 


5 years 


Boys 


41.2 


4i.7 


21.5 


20.5 




Girls 


39-8 


41.4 


21.0 


20.2 


6 years 


Boys 


45-1 


44.1 


23.2 




- 


Girls 


43.8 


43-6 


22.8 




7 years 


Boys 


49-5 


46.2 


23-7 






Girls 


48.0 


45-9 


23-3 




8 years 


Boys 


54-5 


48.2 


24.4 






Girls 


52.9 


48.0 


23-8 




9 years 


Boys 


60.0 


50.1 


25-1 






Girls 


57-5 


49.6 


24-5 




io years 


Boys 


66.6 


52.2 


25.8 


21.0 




Girls 


64. 1 


51.8 


24.7 


20.7 



FEEDING. 511 

m the second year, about three and one-half inches. Thereafter it 
vs between two and three inches a year up to the eleventh year. 

Development of the Muscles. — About the fourth month a child 
begins intelligently to grasp articles within his reach. About the 
seventh month he is able to sit upright for a short space of time. At 
ten or eleven he stands with slight assistance; and walks with ease 
in the fourteenth month. While all of these acts are performed by 
some children at an earlier age than that indicated it must be remem- 
bered that there are many children who do not perform these acts until 
a later period. Some children walk well as early as ten months; there 
are other who do not until seventeen months. Under no conditions 
should a child be urged or encouraged to walk. He will do this of 
his own accord as soon as his legs are strong enough to bear his 
weight. Apparatus for bearing his weight before the proper time to 
walk is certainly injurious. 

Development of Sight. — Practically all that a newborn child 
recognizes by his eyes is the annoyance of light* which is shown by 
closing the eyes against it. A little later he learns to distinguish a 
light and to follow ,it with his eyes. It is probable that sight, as we 
understand it, does not come to him for some months. 

Development of Hearing. — The newborn child is deaf. It is rare 
that any good evidence of the existence of this sense is seen before the 
third month. 

Development of Taste and Smell. — It is probable that these two 
senses are present at birth, as indicated by the action of very young 
infants when placed at the breast. 

Development of Speech. — The first indication of laughing aloud 
appears about the third or fourth month. A child can say single words 
at about one year, and is fairly well able to make simple sentences at 
two years. There are instances of children, mentally quite bright, 
who make no attempt whatever to speak at two years of age. In such 
cases, however, there is great reason to suspect that the child is a 
deaf-mute or is mentally deficient, and he should be tested accordingly 



FEEDING OF CHILDREN. 

Breast Feeding. — There is no substance in nature, nor can there 
be anything prepared by art, which forms so congenial and so wholesome 
a nourishment to the young babe as its mother's milk. It is almost super- 
fluous to remark that nature manifestly intended this fluid as the child's 



512 CARE OF CHILDREN. 

sole nutriment during the early days of life and until the primary teeth 
appear. 

Mothers Who Should Not Nurse. — In many cases there is no milk 
secreted in the mother's breasts. There is another class in which the 
milk is not of good quality, which condition, unless the fact has been 
demonstrated in the attempted feeding of previous children, can be 
learned only after the effort has been made and the child's gain in weight 
carefully noted. Mothers who are in delicate health will not be likely to 
supply milk either in sufficient quantity or of a satisfactory quality to 
nourish the child well. Those who suffer from very severe and pro- 
nounced nervousness are very likely to supply a milk which will affect 
the child, if in no greater degree, at least with frequent colic. It is not 
right for a mother who has suffered severely from attendant diseases or 
conditions during childbirth to attempt to suckle her child. This refers 
more particularly to puerperal convulsions, blood poisoning, hemor- 
rhages, and similar conditions. Mothers suffering from tuberculosis in 
any degree should also not attempt breast feeding. Not only is the supply 
usually both insufficient in quantity and lacking in quality, but the drain 
upon the mother's strength will only hasten the progress of her disease, 
to say nothing of the danger of infecting the child. The only recourse 
in all of such cases is either the wet nurse or artificial feeding. 

The Wet Nurse. — In theory the wet nurse is the best substitute for 
mother's milk. But in practice the results are not what might be ex- 
pected. One of the first difficulties which confronts us is the difficulty 
of procuring one that is satisfactory. The class of women who are most 
easily procurable are unfit by reason of bad habits, bad character, or bad 
health. The matter of expense is also to be considered. There was a 
time when the assistance of a wet nurse was* considered the only solution 
of the difficulty of feeding the child when the mother was unable to do 
so. But that was at a time when the science of artificial feeding was 
practically unknown in comparison with the high degree of efficiency to 
which it has now attained. So that in the very great majority of cases, 
recourse may be had to the use of modified cow's milk when the mother's 
milk cannot be used. Still there are many cases when the services of 
a wet nurse are indispensable. Infants prematurely born, those who 
are extremely delicate, and those troubled with serious intestinal and 
gastric dyspepsia are often wholly dependent upon her for their lives. 

Mixed Feeding. — A condition often exists where the mother's milk 
is of excellent quality and deficient only in quantity. There is no reason 
why the mother's supply should not be used as far as it will go and then 



FEEDING. 513 

supplement it with artificial feeding. Such an arrangement is beneficial 
to the child, and when the proper time comes it lessens the difficulties of 
weaning the child. It is not well to combine the two methods at the 
same meal, chiefly because the child is getting two sorts of nourishment 
at the one meal, and it is difficult to tell what quantity of food the child 
is getting. 

Care of the Breasts During Nursing. — After each feeding the 
nipples and breasts must be carefully washed, either with plain water 
or with a solution of boric acid of the strength of one ounce to the pint. 
Unless this is done with care the milk which runs into the wrinkles and 
small fissures will cause one of the forms of sore nipples which are so 
hard to cure. Ordinary cleanliness is not sufficient, but the most scrupu- 
lous attention must be regularly given to this matter. 

Training the Child to Nurse. — It will contribute much to the 
mother's immediate welfare and her future comfort if she adopts right 
methods of nursing at the start. During the day the child should be 
wakened to take its feedings according to the table given in the next 
paragraph. At night this is not necessary, as the child will have been 
well nourished during the day, and it and the mother will have all of 
the great benefit of a good night's rest. Not only is the mother's strength 
conserved by this means but a better milk supply for the following day is 
insured. 

Time for Feeding During the First Year. — On the first day the 
child has four feedings in the twenty-four hours; the interval is six 
hours; and the child has one night feeding. These feedings are not so 
much for nourishment as for the laxative effects of the first milk, the 
colostrum. 

On the second day the child has six feedings in the twenty-four 
hours; the intervals are four hours; and there is one night feeding. 
From the third day to the end of the first month the child has ten feed- 
ings a day; the intervals are two hours from the time of beginning one 
feeding until it begins the next feeding; and there are two feedings 
during the night. 

During the second month there are eight feedings during the 
twenty- four hours ; the intervals are two and a half hours ; and there is 
only one feeding at night. 

During the third and fourth months there are seven feedings during 
the twenty- four hours; the intervals are three hours; and there is one 
feeding at night. 

During the rest of the first year, beginning with the fifth month, 



514 CARE OF CHILDREN. 

there are six feedings in the twenty-four hours; the intervals are three 
hours during the day and there is no night feeding. The day is 
considered to begin at seven in the morning and to last until nine at 
night. 

It is to be learned with positive certainty by frequent weighing 
whether or not the child is thriving on the breast milk. If it does 
not, either artificial feeding or mixed feeding must be adopted accord- 
ing to circumstances. No time should be lost in making the change 
just as soon as the indications show that the child is not being properly 
nourished. It is much better for the child to have artificial feeding 
before the digestion has been impaired by improper nursing for some 
weeks or longer. 

Weaning. — The proper time for weaning a child is to some extent 
determined by the progress it is making while being breast fed. If at 
any time the weight of the child becomes stationary, it is better to 
start supplemental feeding at once. If the child is losing weight it is 
absolutely necessary to wean it. Under ordinary circumstances, when 
the child is making satisfactory progress, it is begun at the end of nine 
months. There are some mothers who are able to nurse the child well 
until the end of the year, but this is rather unusual. Some, indeed, 
are unable to do so beyond the sixth month. This of course determines 
the time. It is better to choose a time when the child is well and a 
season that is good. Ordinarily the summer months are not the ones 
usually chosen because of the prevalence of gastric disorders at that 
time. But very often there is no room for choice in the matter; the 
welfare of the child demands a change of food at that particular time 
and there is greater probability of harm resulting from a continuance 
of the breast feeding than from the change to supplemental food. 
Where the case will permit the process is a gradual one. If the mother 
is supplying a large flow of milk there is danger of much harm and 
inconvenience resulting to her from a sudden stopping of the feeding. 
This condition is not always relieved by the use of the breast pump. 
The mother knows something of the conditions she will have to face in 
this process of weaning by her experience when the night meal was 
stopped some time previously. The process will be greatly facilitated 
if the mother has reliable assistance from some one who can give the 
child the feeding in place of the breast. So long as the mother is 
near the child there will be appeals that she will not be able to resist, 
and the unwisdom of yielding at this time only increases the difficulty 
for the future. The food that is chosen is some formula of modified 



FEEDING. 515 

milk as given on page 522. It may be that she will be obliged to select 
a formula for an earlier age than that of her child, for one who has 
been for some months on a modified milk diet may be able to digest a 
larger proportion of milk than one who has been on breast milk. It is 
desirable that about the usual quantity of milk be given. If this is not 
known it will do to start with a gill and increase it at the next feeding 
if necessary. The same hours of feeding as formerly must be carefully 
observed, and the mother must make up her mind not to yield. 

Very often conditions arise which make it imperative that the child 
be weaned suddenly. Such are discovery that the mother is again 
pregnant, development of an infectious or malignant disease, or 
inflammation of the breasts, and the like. Pregnancy in the mother 
does not affect the milk to a degree sufficient to produce marked 
instant results upon the child, but the quality of the milk deteriorates 
and the drain upon the mother is more than she can well stand. The 
effect of menstruation upon the quality of the milk is, in the opinion 
of the majority of authorities, very slight. The greatest change in the 
milk is noted in cases where the menstruation occurs rather late in the 
child's first year. The return of that function is to be considered a 
hint on the part of Nature that weaning would be better begun. If 
menstruation occurs early in the year the child need not be taken from 
the breast for more than a day or two, if at all. 

In gradual weaning the child may have one of the formulas for 
modified milk feedings once a day; after a week or so two such 
feedings a day, and so on, until the breast milk is completely replaced 
by the cow's milk. 

Sterilizing Milk. — Sterilization of milk in the true sense of the 
word means subjecting the milk to such a degree of temperature and 
for so long a time that all of the bacteria and all of their spores are 
destroyed. Practically it is not possible to do this except by boiling 
the milk for an hour or two on three or four successive days. Mani- 
festly this is neither possible nor desirable for feeding purposes. For 
boiled milk is a very different food article from raw milk. Just what 
the exact chemical changes are that boiling brings about in milk is not 
definitely known. But there is a decided change in taste, and it is not 
desirable that milk be kept for so long a time as this process requires. 
It is found that the use of hot water or, better, the practice of boiling 
all of the utensils just before they are required for use, and the adoption 
of a lower temperature for a shorter time destroy nearly all of the 
bacteria and render the spores harmless for a time. This process 
is known as Pasteurization. 



516 CARE "OF CHILDREN. 

Pasteurization of Milk. — There are several sorts of apparatus 
more or less intricate, and nearly all effective for that purpose. They 
are in use in some of the larger dairies and milk laboratories of the 
country. But ordinary milk passes through so many hands that there 
is little certainty that germs of infection are not present. For home 
pasteurization it is only necessary to subject the bottles of milk to the 
effect of steam in a closed vessel for twenty-five or thirty minutes 
and to cool them rapidly at once. There should be provided as many 
bottles as there will be feedings during the day. These bottles should 
be of good annealed glass and not easily liable to break at the varying 
temperatures employed. The milk, cream, and water are mixed 
together and enough put in each bottle for a feeding. The limewater 
is not to be added until after the pasteurizing process, or the addition 
may be postponed until the bottle is needed for use. The bottles are 
then loosely plugged with absorbent cotton, and are placed in the 
steamer, or if that is not at hand the bottles may be placed in water 
the temperature of which is to be maintained at from 150 to 155 
for twenty-five or thirty minutes. The bottles are then tightly corked 
with the absorbent cotton plugs, and placed for a little while in cold 
water and then laid on the ice, where they are to be kept until required 
for use. It is well to provide an extra bottle in case of accidents, 
breakage, or spilling. If only a portion of a bottle has been consumed 
at a feeding the remainder must not be used for a future feeding, 
but be thrown out. This process should be followed out in the prepara- 
tion of modified milk. Absolute cleanliness of utensils is imperative, 
else the care and trouble taken in the treatment of the milk will be 
wasted. 

Peptonizing Milk. — In cases of weak digestion it is often desirable 
to predigest the milk either partially or wholly. This is done by com- 
plete or partial peptonizing. 

To partially peptonize milk, place one pint of fresh milk and four 
ounces of water in a bottle; add five grains of the extract of pancreas 
and fifteen grains of the bicarbonate of soda; and place the bottle in a 
pan of water at a temperature of from 105 to 11 5 , or at just such 
a heat as the hand can comfortably bear. It is to remain there from 
six to twenty minutes. At the end of ten minutes the milk will begin 
to assume a bitter taste, due to the process of digestion which has 
been started. This bitterness increases in proportion to the length of 
time the heat is continued. The number of minutes the milk is to be 
treated depends upon experiment. When the process has continued 



FEEDING. 517 

long enough, the peptonizing must be stopped, not merely by taking 
it out of the water, but by subjecting it to cold at once. If the milk is 
to be used at once this is not necessary; if it is to be kept for some 
time it will better be allowed to simmer. The tubes of the extract of 
pancreas are better than the tablets of the same, and may be procured 
ready for use from a druggist. 

To peptonize completely, continue the heating process for two hours. 
Milk thus treated will be bitter in taste, but an infant will soon get 
used to the taste. For older persons a little lemon juice and sugar may 
be added to disguise the taste. Where the milk is to be used for very 
young children it is better to peptonize it full strength as above sug- 
gested, and then to dilute it as needed. There is objection to the 
continued use of peptonized milk as it usurps the functions of the 
stomach and the proper treatment of the diseases in which this is used 
is to strengthen the stomach and to render it able to do its own work 
without assistance. So peptonized food is used only to help it in its 
weakness and to restore its powers. When there are indications that 
this point has been reached the peptonized food should be gradually 
withdrawn. 

Condensed Milk. — This, of course, is not so good as plain milk ; yet 
it forms the staple article of food of many children. There are occa- 
sions when condensed milk is the only form in which milk can be either 
gotten or kept. In the process of manufacture it is necessary to remove 
much of the cream in order to dry the milk. This robs it of its fat; 
and, when it is used as infant's food, this must be supplied in some form. 
The easiest way is to give from five to twenty drop doses of cod-liver 
oil. In its natural state condensed milk is not to be given to children. 
For a very young infant, it should be diluted with twelve times its 
bulk of water. For a child of six months, six times the bulk; that is, 
six spoonfuls of water to one level spoonful of condensed milk. In this 
form it is, perhaps, more digestible than plain milk or than modified 
milk, but it is much less nourishing. When fresh cow's milk 
of good quality can be obtained, condensed milk should never be 
used. 

Infant Foods. — However valuable these may be on occasions, it must 
be said that these preparations do not compare with modified milk as 
a permanent food. The chief disorders resulting from their prolonged 
use are scurvy in children and rickets. Some of them are intended to be 
used alone, or with the addition of water only; others, less objec- 
tionable, are prepared by the addition of milk, 



5i8 



CARE OF CHILDREN. 



Cow's Milk. — When for any of the many reasons the mother's milk 
is not suitable in quantity or in quality as food for the infant, and when 
a wet nurse is out of the question, as it so often is, recourse must be had 
to the next best article for the child's nourishment. This is cow's milk. 
The essential points to be first looked to are that the milk used is pure 
and clean. Conditions attending milk supply have undergone a great 
change during the past few years, and it is now possible to meet both 
of these conditions with much greater success than formerly. In country 
districts these essentials are more directly under the mother's control 
than is the case in the city. But a little judicious inquiry will soon put 
one right in these matters. Milk is considered to be pure when it is 

delivered just as it comes from the cow, without 
adulteration or manipulation of any sort. The 
idea that one cow's milk is the best for an infant 
is an erroneous one. If that particular cow be 
affected by a disease, such as tuberculosis so 
A common among cows, the danger of infection 

i\ 6=t from the milk is greater than will be the case if 

that cow's milk be mixed with that of the rest 
of the herd which are healthy. Another point 
to be observed is that the milk be not more than 
twenty-four hours old when the child gets it. It 
is also important that the milk show a fair pro- 
portion of cream after standing a few hours. It 
is perhaps needless to say that the milk must be 
sweet and free from disagreeable odors or taste. 
These points are easily detected by a careful 
examination. 
Modification of Cow's Milk. — While mother's milk and cow's milk 
are composed of the same ingredients, they are not present in the same 
proportions. It is therefore necessary to so change the proportions of 
the cow's milk as to make it more nearly correspond to mother's milk. 
This change is called modification. To do this intelligently one must 
know the composition of both mother's milk and cow's milk. 

In the first place both are largely made up of water, which is present 
in about the same proportion in both, namely, 87 per cent. Or, in other 
words, if 100 spoonfuls of either milk be taken, 87 spoonfuls are water; 
the other 13 spoonfuls, or 13 per cent, are composed of fat, sugar, 
proteids, and salts. It is among these that the disproportion exists. The 
fat is the cream ; the sugar is milk sugar ; the proteids are the curd of 




Fig. 64. An Excellent 
Form of Graduated 
Nursing Bottle, 
easily cleansed 



FEEDING. 



519 



the milk ; and the salts are dissolved in the water of the milk. The 
fat or cream is about the same in both milks, and in 100 spoonfuls there 
would be about four spoonfuls of fat or cream in each. That is what is 
meant by four per cent of fat in the food. But the great difference in 
the composition of the two milks is in the proportion of the other con- 
stituents. In mother's milk there is 7 per cent of milk sugar, 
while in cow's milk there is only 4*4 per cent. There is only iy 2 
per cent of proteids, or curds, in mother's milk, while there is 4 per 
cent in cow's milk. There is yl of 1 per cent of salts in cow's milk, 
while there is only from 1-5 to y per cent in mother's milk. So that 
in order to modify cow's milk to make it more nearly like mother's 
milk it is necessary to increase the quantity of sugar and to decrease 
the quantity of proteids, or curds. 

The following table will show more conveniently the relative pro- 
portions of each constituent in the two milks : — 

Mother's Milk. Cow's Milk. 

Fat, 4 per cent. Fat, 4 per cent. 

Sugar, 7 per cent. Sugar, 434 per cent. 

Proteids, \y 2 per cent. Proteids, 4 per cent. 

Salts, 1-5 to J4 P er cen t- Salts, J4 P er cent. 

Water, 87 per cent. Water, 87 per cent. 

Why It is Necessary to Modify the Milk. — Simply because a child 
cannot digest it. Not only are the proteids, curds, present in too 
large proportions but even if reduced to the same proportions as are 
present in mother's milk they are then harder to digest than are the 
proteids in mother's milk. It is true that a child's stomach will in time 
become strong enough to digest it in its full strength, but that is not 
until the end of the third year generally and sometimes not then. It 
is also necessary to add sugar to the cow's milk, not to make it sweeter, 
but to supply the deficiency of sugar, which is real food to the child. 
As the child becomes able to digest the milk more easily as it grows 
older it is necessary to change the formula for modifying milk from 
time to time. Then, also, as the digestive power of children of the 
same age varies considerably it is necessary to modify the milk for one 
child according to one formula and that for another child according 
to another formula. It is usually the custom for the doctor to prescribe 
the proper proportions for mixing or modifying milk; but as the mother 
is on the ground all of the time, and as the methods of modifying are 
quite within her power to grasp easily, the best results are to be 
expected from her management. 



520 



CARE OF CHILDREN. 



How is Cow's Milk Modified? — The results which it is desired to 
bring about by modifying cow's milk are as follows : — 

1. As cow's milk is acid and mother's milk alkaline, it is necessary 
to make the cow's milk alkaline by adding limewater. 

2. As cow's milk contains less sugar than does mother's milk, it is 
necessary to add sugar to the cow's milk. 

3. As cow's milk contains more proteids (curds) than does mother's 
milk, it is necessary to reduce the quantity of proteids by diluting the 
cow's milkwith water. 

4. When the cow's milk has been sufficiently diluted with water to 
bring about the proper proportion of proteids, the proportion of fat 
(cream) which was originally in the cow's milk has also been reduced. 
It is therefore necessary to restore the proper proportion of fat by the 
addition of cream. 




Fig. 65. Proportion of Milk to be taken in Getting 
the Several Percentages of Fat. 



The acidity of cow's milk is overcome by the addition of either lime- 
water or the bicarbonate of soda (baking soda). It is best added last, 
after the other steps in modification have been taken. Then, if lime- 
water is used, add one ounce of limewater to every twenty ounces of 
food. If bicarbonate of soda is used, add twenty grains of bicarbonate 
of soda to every twenty ounces of food. 

Sugar is added after the dilution of the milk by water. Sugar of 
milk is to be preferred. It is true that it is more expensive than cane 
sugar. Some children will take the cane sugar very nicely; whether or 
not it agrees with a child is a matter of experience. The amount of milk 
sugar to be added to the food varies with the age of the child. During 
the first five months add one ounce of milk sugar to twenty ounces of 
food. The sugar is dissolved in water that has been boiled, and in this 



FEEDING. 



52i 



way added to the food. If cane sugar is used, a much less quantity is 
required. Usually not more than half the amount of milk sugar, about 
half an ounce to twenty ounces of food, should be used. If more is added 
than is necessary, the sugar will ferment in the stomach and cause colic. 
The proteids of cow's milk are reduced by the addition of water. We 
have seen that there is about twice as much proteids in cow's milk as in 
mother's milk, and it would appear at first sight that it would bring the 
right proportions if we add two parts of water to one of milk. This 
would be true if the proteids in both were of the same degree of digesti- 
bility. But the proteids of cow's milk are much harder to digest than 
are the proteids of mother's milk. So for very young infants it is neces- 
sary to dilute the milk with five or six parts of water to one of milk. 
This seems a great deal but it is all that the stomach of a very young child 
can stand. As the child grows older these proportions are considerably 
changed. By the dilution of the milk in the 
degree just referred to, it will be seen that the 
proportion of fat (cream) which the milk 
originally contained, has been very much re- 
duced. In order to restore the proper balance, 
it is then necessary to add more cream. This 
may be done in several ways, but the most con- 
venient is by using the top milk. It is quite 
plain that if a bottle of milk stands for four or 
five hours, the cream will rise to the top. If 
we take off" all the cream and only a part of the 
remaining milk, we have a far richer fat food 
than if we take the whole of the milk. The 
average milk, as we have seen, is composed of FlG - 66, A Chapin Dipper 

r , Tl . , and Method of Using to 

four per cent cream. It is customary to speak 

of it as a four per cent milk. If we take the 

upper third of a bottle of milk that has been 

standing for four hours, we shall have ten per 

cent of cream instead of only four per cent. Such milk is called ten per 

cent milk. If we take the upper half of such a bottle of milk, we shall 

have seven per cent of cream, or a seven per cent milk. 

The removal of the top milk is best accomplished by means of a 

Chapin dipper. This holds one ounce of milk. It is used by pressing 

it carefully downwards on the surface of the milk, taking care not to 

disturb the contents while it is filling. It is impossible to pour off the 

top milk, so some such device as this is needed. 




take off the top mllk 
without disturbing the 
Lower Layer. 



522 CARE OF CHILDREN. 

Formulas for Modified Milk. — It may be necessary in some cases 
to vary the time of change from one to another formula. If the child 
is digesting the milk and seems unsatisfied, it is well to advance to the 
next formula. But if on doing so the child is observed not to digest the 
milk well it will be necessary then to go back to the original for a little 
while longer. At the same time the child's weight should be frequently 
taken, and this will indicate whether or not the food is adequate. 

For the Second Day. 

Ten per cent Milk, 2 ounces. 

Milk Sugar, 1 ounce. 

Limewater, 1 ounce. 

Boiled Water, 17 ounces. 

Make up twenty ounces. Keep in bottles in a cool place, and keep 
the bottles corked with absorbent cotton. 

Give from one to one and one-half ounces at a feeding every two 
hours during the day and twice during the night. 

For the Fourth Day. 

Ten per cent Milk, 3 ounces. 

Milk Sugar, 1 ounce. 

Limewater, . 1 ounce. 

Boiled Water, 16 ounces. 

Keep as previously directed. 

Give from one to one and one-half ounces at a feeding every two 
hours during the day and twice at night. 

For the Tenth Day. 

Ten per cent Milk, 4 ounces. 

Milk Sugar, . . . 1 ounce. 

Limewater, 1 ounce. 

Boiled Water, 15 ounces. 

Keep as previously directed. 

Give from one and one-half to three ounces at a feeding every two 
hours during the day and twice during the night. 

For the Fifth Week. 
(A little earlier in the case of strong infants with good digestion; 
and later in the case of delicate children.) 

Ten per cent Milk, 5 ounces. 

Limewater, ' . . . . 1 ounce. 

Milk Sugar, 1 ounce. 

Boiled Water, 14 ounces. 

Keep as previously directed. 

Give from two and one-half to three and one-half ounces every two 
hours during the day and once during the night. 



FEEDING. 523 

For about the Seventh to Ninth Week. 

Ten per cent Milk, 6 ounces. 

Sugar of Milk, 1 ounce. 

Limewater, 1 ounce. 

Boiled Water, 13 ounces. 

Keep as before directed. 

Give from three to five ounces every two and one-half hours during 
the day and once during the night. 

For the Third or Fourth Month. 

At this period the child's powers of digestion have increased so that 
it is now able to take a greater proportion of proteids. This is secured 
by using the seven per cent milk, which is gotten by using the top 
half of the bottle of milk instead of the top third as formerly. The 
formula reads : — 

Seven per cent Milk, 7 ounces. 

Milk Sugar, 1 ounce. 

Limewater, 1 ounce. 

Boiled Water, -. 12 ounces. 

Keep as previously directed and give from four to six ounces at a 
feeding every three hours during the day and once during the night. 
Continue this formula for about ten days, after which : — 

Seven per cent Milk, 8 ounces. 

Milk Sugar, 1 ounce. 

Limewater, 1 ounce. 

Boiled W r ater, 11 ounces. 

Keep as before and give from four to six ounces at a feeding every 
three hours during the day and once during the night. 

Continue this formula for about two weeks, after which : — 

Seven per cent Milk, 9 ounces. 

Limewater, 1 ounce. 

Milk Sugar, 1 ounce. 

Boiled Water, 10 ounces. 

Keep as before and give from four to six ounces at a feeding every 
three hours during the day and once during the night. 
For the Fifth and Sixth Months. 

Seven per cent Milk, 10 ounces. 

Milk Sugar, 1 ounce. 

Limewater, 1 ounce. 

Boiled Water, .5 ounces. 

Barley Gruel, 4 ounces. 

Keep as before and give from five to seven and one-half ounces at 



524 CARE OF CHILDREN. 

a feeding every three hours during the day. The night feeding may 
now be omitted. 

For the Seventh, Eighth, and Ninth Months. 

Seven per cent Milk, 1 1 ounces. 

Milk Sugar, z/ A ounce. 

Limewater, i ounce. 

Boiled Water, 3 ounces. 

Barley Gruel, 5 ounces. 

Keep as before and give from five to seven and one-half ounces at a 
feeding every three hours during the day. The night feeding is now 
omitted. 

In the Tenth and Eleventh Months. 

At this time we begin to prepare the child for a plain milk diet. 
This is done gradually; one feeding a day of plain milk and barley 
water; then later two feedings a day; then three a day; and so on until 
a plain milk diet is very slowly obtained. At the beginning of this plan 
the child should take as one of his feedings each day for about two 
weeks : — 

Plain Milk, $y 2 ounces. 

Barley Gruel, 2 y 2 ounces. 

At the end of two weeks of such feeding he should get two such 
feedings a day. The two feedings should be given for about another 
two weeks, then three feedings a day should be given. After these 
have progressed for a week, the quantity of plain milk may be increased 
to:— 

Plain Milk, 6 ounces. 

Barley Gruel, 3 ounces. 

This is given for a week or so at the rate of three feedings a day, 
then increased to four feedings a day. Probably this number will have 
to be continued for more than two weeks ; a month would be better, 
during which time the quantity may be still further increased to : — 

Plain Milk, 7 ounces. 

Barley Gruel, 2 ounces. 

By the time the child is fifteen months old he should be taking plain 
milk at the rate of five feedings in the twenty-four hours, at intervals 
of about foui hours apart. The barley gruel may be continued and fed 
separately by a spoon. By the end of the first year the child may 
take some fruit in the form of orange juice, the white of an egg, and 
some beef juice. 



FEEDING. 525 

Diet for a Child of One Year. 
6.30 a. m. : — 

Plain Milk, 7 ounces. 

Barley Gruel, 3 ounces. 

Granulated Sugar, y 2 teaspoonful. 

Salt, 1 pinch. 

10 a. m. Same as above. 

2 p. m. : — 

One or two ounces of Beef Juice, three times a week. 

A Soft Boiled Egg, twice a week. 

Chicken or Mutton Broth, from 4 to 6 ounces, twice 
a week. 

Plain Milk, 3^ ounces. 

Barley Gruel, iy 2 ounces. 

Sugar and Salt, to suit. 

6 p. m. Same as first meal. 
10 p. m. Same as first meal. 

Diet for a Child Fifteen Months Old. 

The number of meals and the hours of feeding remain the same as 
given for a child of one year. Milk continues to be the chief article 
of food and remains so for the next two or three years. In the 
morning ten ounces of milk are given, more or less mixed with barley, 
wheat, or oatmeal gruel. This is being gradually lessened so that the 
milk is approaching plain milk as fast as the stomach of the child will 
accept it. As has been pointed out there is a very great difference in 
the capacity of children to take plain milk; and the proportions as well 
as the quantities named in the formulas are subject to considerable 
change. A strong, hearty child with good digestion may be several 
weeks ahead of a delicate, small child in the matter of quantity and 
strength of the mixture. This is purely- a matter of experiment and all 
changes made must be introduced very carefully and with attention to 
the digestion of the food and the increase in weight of the child. Some 
children are so susceptible to changes that the too early or too rapid 
change to a new diet is attended with marked digestive disturbance. In 
such cases it is necessary to go back to the former diet for a time; 
and in some cases going back two or even three steps for a day or two 
may be necessary. Instead of mixing the gruel with the milk, it may 
be possible to give it separately at the second meal. It is then limited 
to two teaspoonfuls of cereal, such as oatmeal, or wheaten grits. The 
essential thing in this preparation is to see that the cereal is cooked 



526 CARE OF CHILDREN. 

for three or four hours. It is strained and served with a little cream. 
As the child has had cream with the cereal, it can take plain milk in 
less quantity than was given at the first meal. The third meal is the 
heartiest of the day. That is the time to give beef juice, and if the 
teeth are well through some scraped beef or mutton pulp may be given. 
The amount is limited at first to a single teaspoonful at a meal. Well 
boiled rice, very stale bread, at least a day old, or zwieback, a table- 
spoonful or two of the pulp of prunes (the skin must be carefully 
removed), and a small quantity of milk will make up the meal. The 
milk at this age is to be taken from a spoon, or, better, from a cup, 
except for the last meal of the day, when it may still be taken from 
the bottle. The fourth meal may be made up of milk with the addi- 
tion of some arrowroot or similar food. The last meal of the day 
is made up of plain milk. 

Diet for a Child Two Years Old. — The first meal is still composed 
of plain milk. The second is of cereals, which no longer require to be 
strained. A thin slice of stale bread may be given without butter, for 
the child has had all the fat that is needed in the cream used on the 
cereal. The third meal is made up of the pulp of beef or mutton ; broths 
may be used three times a week ; on other days a soft boiled egg mixed 
with bread crumbs ; stale bread, no butter, and prune pulp. It is advis- 
able not to give milk at this meal, water is much better when meat forms 
a part of the meal. Baked apple or apple sauce without much sugar 
may be used instead of the prune pulp. Raw apples should not be given. 
The fourth meal consists, as before, of arrowroot, barley, cornstarch, or 
bread and milk. The last meal is, as formerly, composed exclusively 
of milk. 

Diet During the Third Year. — Very early in the third year the last 
or fifth meal may be dropped, and the hours of the other meals will be 
as formerly at from 6.30 to 7 a. m., 12 to 1, 3.30 to 4, and 
6.30 p. m. It may be, however, that the child will have difficulty 
in going to sleep without the accustomed late meal. In such cases the 
child may be given a cup of warm milk for a time in place of the last 
meal. Very strict observance of the rule that when the meals are given 
regularly and promptly there should be no eating between meals is now 
of the highest importance. Now, also, he should be taught to chew his 
food well. So much in the way of good digestion depends upon how 
well this act is performed. Besides the child is now beginning to eat 
a greater variety of food, and digestive disturbances are very easily 
excited at this time. In order to restrict a child's diet to proper articles,' 



FEEDING. 



527 



it is vastly better that he take his meals alone rather than with the rest 
of the family. Where there is more than one child this is often 
easier to manage than in the case of a single child. It is quite unreason- 
able to expect a child to sit at the table with adults and not be expected 
to ask for the food prepared for them. 

Milk forms a large part of the child's diet until the period of the 
second teething. It may be regarded as the principal article of food 
both in sickness and in health during the third and fourth years. In 
cases of digestive disturbance it is the best food to turn to, because by 
dilution with water it is so easily capable of being readily adjusted to 
the child's powers of assimilation. It will be seen when these digestive 
irregularities are discussed that it is sometimes necessary to put a three- 
year-old child back for a time on even first year modification of milk in 
order to supply him with food that he can digest. The cream is always 
an important article of food; for in health it supplies a child with the 
needed proportion of fat, and in constipation it is useful as a natural 
laxative. When no longer mixed with the milk to modify it, it is 
eaten with cereals, and the amount taken is to be regulated by the 
condition of the child's bowels. Where cream is eaten in any quantity, 
say two ounces at a meal, there is no need of giving the child butter, 
for this it must be remembered is only another form of the fat of milk. 

Eggs may be introduced at the latter part of the second or first 
part of the third year. It is perhaps needless to say that they are never 
to be given fried to any child. Some form of soft boiling, or poaching, 
is the best way. They are not to be given more than three times a 
week, because if given oftener there is great danger that the child will 
get tired of them. The list of foods which a child at this age may take 
safely is naturally limited and it is well to be able to supply a change 
when required. So when a child shows signs of tiring, even in slight 
degree, of any one article another should be at once substituted. 

Meats are valuable food when well chosen. The first form in which 
they are given is as broth and meat juice. There is very little nourish- 
ment in broth. Their chief use is as a stimulant. An adult takes a 
small quantity of soup at dinner not as a food article but as a pre- 
liminary to excite the function of the stomach to the more serious work 
which is to follow. They do form excellent vehicles to convey more 
nutritious matter in the form of barley, rice, vermicelli, and vegetables. 
With the exception of potato soup all such are to be strained before 
feeding. The plainer they are made the better. Beef juice is more 
nourishing and is prepared either by a meat press or by extracting the 



528 CARE OF CHILDREN. 

juice with water. The meat press is much the better way of preparing 
the juice. The meat is first browned slightly on a quick pan so as to 
sear the outside and to start the juice. The meat is not cooked and 
the pan must be very hot, yet the meat must not be burned. It is then 
put in the press. It is better to prepare the juice as required ; only one 
or two ounces of the juice, according to the age of the child, will be 
needed at a time. A lemon squeezer will answer the purpose of a meat 
press very well. Another way without using the press is to take a 
pound of very lean chopped beef, place it in a jar and pour on eight 
ounces (half a pint) of water and allow it to stand for eight or ten 
hours. The water is then poured off and the rest of the juice is 
squeezed out of the meat by wrapping it in coarse muslin. In all cases 
a little salt is added to the juice and it is to be given at a heat of about 
ioo°. If the child does not take it well in this form it may be added 
to the milk, where it will not be noticed. But the milk must not be 
heated above the ioo° mark, as the albumen in the beef juice will be 
coagulated by greater heat. Practically the only kinds of meat which 
a child can take are beef and mutton. In poultry he is limited to fowl 
and turkey. The meat of young, immature animals is not to be given, 
for it is indigestible. This precludes lamb, veal, and chicken. This 
does not mean that old, tough birds and animals are to be chosen, 
but that the animals and birds while young must be full grown. The 
meat in all cases is to be given rare, and at first it is scraped after cook- 
ing. This supplies a sort of pulp which is quite within the child's 
powers of digestion and of mastication. Broiling the beefsteak or the 
chop is the best way to cook the meat. From one to two tablespoonfuls 
of the scraped pulp at the midday meal is the * way it is best taken. 

Fish is a permissible article of diet for young children with certain 
very well defined limitations. Only absolutely fresh fish may be safely 
given. Salted or smoked fish are never to be given. Some fish, such 
as salmon and herring, are too fat for young children. Oysters may be 
given stewed rather as a change and a treat than as a frequent (fish. 
Oysters and clams may be used to maka a thin soup, but all particles 
of the meat must be removed before serving. The best way to prepare 
fish is to broil or boil them. But fish are never to be served to children 
with a rich sauce. A little cream may be added, but a sprinkling of salt 
is all that is needed. 

Among the vegetables suitable for children the potato takes the first 
place. The white potato is better than the sweet potato, as the latter is 
so seldom as mealy as is necessary to easy digestion. Baking produces 



RICKETS. 529 

a more easily digested food than boiling. Potatoes are never to be 
given stewed or fried or sauted.. New potatoes are not ripe and are 
unfit for children. Well cooked, tender asparagus tops, tender peas, 
string beans, cauliflower, and spinach are within the digestive abilities 
of young children. Dried beans are not safe food for children under 
six. Spinach is the chief vegetable for winter use. Canned vegetables 
are not to be given. Celery may be given if stewed, but never raw. 



DISEASES OF CHILDREN CAUSED BY 
IMPROPER FEEDING. 

RICKETS. 

A disease of early childhood marked by changes in the bones, with 
consequent deformity, muscular weakness, and nervous disturbance. It 
usually appears between the ages of six months and two years. 

Causes. — It is markedly a disease of improper feeding. Artificially 
fed children suffer most from it. Children fed with proprietary foods 
are very subject to it, because these foods are deficient in fat and too 
rich in starch and sugar. The same is true of condensed milk. When 
improper feeding is combined with an unhygienic mode of life, such as 
foul air, lack of sunshine, dampness and poverty, the disease is almost 
certain to appear. 

Symptoms. — A change in the shape of the head and deformity of the 
limbs, due to disease of the bones, may be among the earlier symptoms. 
The head becomes square or box-like in appearance; the bones of the 
forehead over the eyes become prominent, as do also the bones at the back 
of the head. This gives the head the appearance of having ' four 
corners. The long bones of the legs become soft and unable to 
bear the weight of the body, so that bowlegs and knock-knees are 
produced. The chest becomes pigeon-breasted and there is often curva- 
ture of the spine. The joints at the wrists and ankles become enlarged; 
and along the sides of the breastbone the ends of the ribs at their points 
of union with the breastbone assume a rounded shape much like marbles. 
These take the name of the "rachitic rosary." Very often there is rest- 
lessness at night ; f everishness ; profuse perspiration of the head, so that 
the pillow is often found wet; slight diarrhoea; nausea and vomiting; 
and the peculiar enlargement of the abdomen caused partly by the accu- 
mulation of gas and partly by the loss of tone in the abdominal wall. 



530 CARE OF CHILDREN. 

Teething is usually slow, and the teeth are generally very irregular when 
they do come. Nervousness and sometimes convulsions are to be observed 
in many cases. 

Prognosis. — Children do not die from rickets, but their power of 
resistance to other diseases which they are very liable to contract is so 
much lessened that they succumb to one of them. The deformities 
caused by the disease are often permanent, especially in cases of great 
severity or in those in which there has been considerable progress 
before it was detected. 

Treatment. — The treatment calls for an immediate change of the 
diet. If the child is being breast fed, modified milk adapted to the 
age and digestive powers of the child must be substituted. If the child 
is taking a proprietary food its use must be stopped or limited. Starch 
and sugars are to be reduced to a minimum or prohibited altogether. 
If the child is old enough it should have beef juice, eggs, scraped beef 
or beef pulp, and fresh fruit, especially orange juice. The deficiency 
of fat is to be supplied by cod-liver oil given in doses of from five to 
twenty drops at the beginning according to the age of the child. It 
must not be given in quantities beyond the power of the child to 
assimilate. Bad hygienic conditions are to be overcome by giving the 
child the maximum of fresh air. If he can live in the country, so much 
the better; and he is to be encouraged to take all possible outdoor 
exercise. Cold sponge baths, if they can be borne, and plenty of 
sunshine are in themselves valuable remedial agents. 

If the deformity of bowlegs is not very pronounced the chances 
are very good that the child will outgrow them in a great measure, 
if not entirely. The use of braces to correct the deformity is not 
always successful; and where the legs are much bowed it is as well to 
let them alone until the child is five or six years old and then have an 
operation performed by a skillful orthopaedic surgeon. 

SIMPLE WASTING OR MARASMUS. 

A gradual wasting of the tissues of the bodies of infants usually 
without attendant organic disease. 

Causes. — Insufficient or imperfect food supply; poor digestion; 
unhygienic living; or weak constitution. There are loss of weight, poor 
circulation, imperfect breathing, and consequent impoverishment of the 
blood. The child gradually wastes away until it is little more than skin 
and bone; the stomach is abnormally large; anaemia with marked pale- 



SCURVY. 



531 



ness is a prominent symptom. The stools contain a quantity of undi- 
gested food and are often otherwise normal, or contain a small quantity 
of mucus. Vomiting is also common; and the appetite is poor. In the 
last stages the child will eat nothing, and, unless fed forcibly, will die of 
starvation. 

Prognosis. — When the disease attacks children under four months 
of age the chances of recovery are not good; the later it appears the 
better the prognosis. A history of the cases shows that those who 
recover, do so completely, and at three years of age are quite vigorous, 
though their weight and size may be below the average of that age. 

Treatment. — A radical and complete change in the diet of such chil- 
dren is the first necessity. This generally requires the services of a wet 
nurse or the employment of modified cow's milk. The modification of 
the milk will probably be lower than that of a child of the same age in 
good health. It may be necessary to employ a very dilute form, as the 
great need is milk of a quality and strength that is within the power of 
the child to digest easily. It is usually necessary to peptonize the food 
so as to predigest it. This is practically the condition which affects 
children of premature birth, and those of an enfeebled constitution. In such 
cases it will be necessary to follow the directions for the care and treat- 
ment of such children. As the breathing of these children is only partial, 
it is advisable to use such means as will cause them to breathe more 
deeply. This is effected by their crying. When this is produced by 
spanking the child, the method seems a little inhuman, and the same 
result can be produced by giving the child a cold sponge bath quickly 
just after the warm bath. This must be done hastily and without ex- 
posure. Good, intelligent nursing counts for much more than medicine. 
Plenty of fresh air, if the child is able to go out and the weather is fit. 
and ventilation of the room by day and night, with frequent systematic 
airing of the room, are indispensable. 

SCURVY OR SCORBUTUS. 

A constitutional disease, which most commonly affects the children 
of the well-to-do. While children of the poor are more largely affected 
by rickets, the children of those in more comfortable circumstances suffer 
from scurvy. 

Causes. — These are essentially errors in feeding. A child may 
receive food of good quality, yet it is often lacking in important con- 
stituents. The disease is the result of long continuance of errors in diet. 



532 CARE OF CHILDREN. 

Cases may develop from feeding of any sort of food; but the greater 
number are seen in children who are fed on sterilized milk, condensed 
milk, and prepared foods. 

Symptoms. — One of the earliest symptoms is marked pain and ten- 
derness of the legs. This is often so great as to cause the child to cry 
out when the parts are handled ; and often causes a suspicion of rheuma- 
tism. But very soon the characteristic symptoms appear in the mouth : 
purple, swollen gums, which bleed very easily; even a slight rubbing of the 
gums will provoke bleeding; the gums may swell so as to completely 
cover the teeth; swelling of the joints; the occurrence of "black-and-blue" 
spots around the joints, caused by a hemorrhage under the skin ; loss of 
power in the limbs which suggests paralysis; the child is anaemic, and 
internal hemorrhages occur, the blood being voided by vomiting, in the 
stools, or in the urine. 

Prognosis. — If the disease is detected in time and proper treatment 
given, the recovery is very rapid; but where the disease has made con- 
siderable progress unobserved, the prognosis is not favorable in young 
children. Fatal cases usually run for from four to six months, or some- 
times less. 

Treatment. — As in all cases of disease from faulty nutrition, the 
first step is the correction of the diet. In most cases this, if properly 
done, is all that is required to effect a cure. A properly modified cow's 
milk diet will produce rapid changes for the better. This modification 
and the degree of dilution is a matter of experiment. To this is to be 
added the juice of ripe fruit, especially that of the orange. This should 
not be given with the milk, but about an hour before, and should amount 
to from one-half an ounce to three or four ounces a day, according to 
the age of the child. If there is diarrhoea, resulting from intestinal indi- 
gestion, the fruit juices should be given with great caution. The pres- 
ence of complications, of course, affect the treatment. Where there is 
anaemia, the bitter wine of iron, cod-liver oil, and nux vomica are called 
for after the other symptoms have subsided under the influence of good 
diet. On account of the extreme pain and tenderness of the limbs, in 
most cases, the child should be handled as little as possible. While fresh 
air is important and must be provided, there is need of great care to 
prevent exposure, as such children are very susceptible to cold. 

In the case of an older child the diet will be varied by the use of 
beef juice and fresh vegetables. The potato especially is of value; in 
winter, spinach is the most valuable fresh vegetable. 



HARELIP. 533 

DISEASES OF THE DIGESTIVE ORGANS. 

MALFORMATIONS OF THE MOUTH. 

Harelip. — The development of the parts has been arrested so that 
there is no union. The opening in the lip is never in the middle line of 
the face, but on one or both sides, under the opening of the nostril. It 
is either single or double. 

Symptoms. — The only symptom is the evidence of the deformity. 
The deformity may be so great as to prevent the child from nursing 
through inability to grasp the nipple. That leads to imperfect nutrition, 
and it will be necessary to operate at once. Where the deformity is not 
so great as to interfere with nursing, the operation will better be post- 
poned until the fifth month. 

Treatment. — The operation is quite simple, calling only for nicety 
of adjustment of the parts so as to leave very slight traces of the healed 
wound. 

Cleft Palate. — This is a similar lack of union through arrested devel- 
opment. It frequently accompanies harelip, and the parts involved vary 
in different cases. 

Symptoms. — There is the evidence of deformity, and when the child 
is old enough to begin to speak, there is noticeable a characteristic imper- 
fect utterance. Sometimes the deformity is so great as to interfere with 
nursing, and the operation must be performed at once. Otherwise it 
is better to postpone it until the tenth year. 

Treatment. — There is the greatest need of cleanliness during infancy, 
as the accumulation of particles of food in the uneven surfaces of the 
mouth induces thrush, and other forms of sore mouth. The operation 
is more difficult that that of harelip, but it is not attended by any 
danger. 

Tongue-Tie. — This form is caused by the undue shortness of the 
membrane (the frenum), which is attached to the tongue on the under- 
side. 

Symptoms. — The earliest indication of it is usually a difficulty in 
nursing, and the inability to thrust the tongue out. It can be detected 
when the child opens its mouth in crying. 

Treatment. — Unless the defect is so great as to interfere with nurs- 
ing, no operation is needed. If a child can thrust its tongue out beyond 
the red edge of the under lip, it is not to be regarded as an infirmity. 
Where an operation is called for, it is very easily performed by the cut- 
ting of the frenum. 



534 CARE OF CHILDREN. 

TEETH AND TEETHING. 

What we may expect to occur in the case of the normal development 
of a child's teeth will largely depend upon how the mother shall care for 
baby's mouth. So in the beginning, let our watchword be, Cleanliness. 
In these scientific days, cleanliness means more than ever before. It is 
to this word we must give the credit as being the foundation for success 
in the treatment of many infectious diseases. And it is to this one thing 
in the work of sterilization that modern surgery owes much for i f z suc- 
cess. As well is it a most important factor in the treatment of dental 
affections, for the necessity of sterilization is founded upon just as firm 
a basis as is the science of mathematics. 

When the baby is very young, its mouth should be cared for many 
times daily to insure healthy mucous membranes and gums, by washing 
it out before every nursing, to prevent any infected mucus or any other 
foreign materials from being carried into the stomach to cause indi- 
gestion. 

To do this in the best and easiest way, procure a glass-stoppered 
bottle, fill it with a saturated solution of boracic acid, being careful to 
scald the bottle beforehand for this purpose, to insure sterilization. To 
prepare this solution, add to one pint of water, which has been previously 
boiled, one heaping teaspoonful of boracic acid, shake well, and it is 
ready for use when dissolved. Water prepared for this purpose should 
be boiled at least ten minutes and should not be left in an open vessel 
exposed to the air, for the air, being laden with bacteria, would soon 
rehabitate the water, defeating the object of boiling entirely. 

Having this solution mixed in the proper proportion and in the bottle 
for use, pour a small quantity each time into a cup or shallow dish, 
enough for one cleansing only, never using solution the second time 
or pouring it back into the supply bottle. By wrapping a piece of clean 
absorbent cotton around either the index or little finger, dip into the 
solution and wash thoroughly the inside of the cheeks, around the gums, 
and both the under and upper sides of the tongue. If much mucus be 
present it may be necessary to use many pieces of cotton to cleanse these 
surfaces, but never introduce the same piece into the mouth or the liquid 
the second time. If sterile cotton for this purpose is not available, any 
fabric in white may be made sterile by the use of dry heat in an oven, 
at any temperature over 212 degrees, for forty minutes. Cloth prepared 
by this method should be cut into appropriate size before baking, so it 
will not have to be handled afterwards until ready for use. Place in a 
covered jar ready for use, using a fresh piece for each washing. 



TEETHING. 



535 



The mother's nipples should be washed with the same solution before 
nursing. 

For a bottle baby, much care should be exercised in keeping the rubber 
nipple clean, as here is the source of many mouth affections in infantile 
life. The rubber nipple should be scalded and put into a solution of borax 
until needed. 

Early in infant life we should begin to prepare our baby for an ordeal 
which only those who have had recent difficulties in cutting a wisdom 
tooth could appreciate, if they were to multiply their troubles by two to 
four fold. Now, of course, baby's food must be of a suitable character, 
which must be determined by many experiments. 

The food being right, the baby being healthy, I would say give no 
solid food until dentition is nearly completed ; and that prior to dentition, 
use limewater to build up bone and aid digestion. In many cases the 
use of cod-liver oil in an emulsion has proven a great help to infants 
cutting teeth, as it not only tones up their system as a nourishing food, 
thereby aiding dentition, but, being rich in phosphates, aids in the devel- 
opment and hardening of the bones. 

The shape, size, and color of the teeth being a matter of heredity is 
not ours to change, but we may do much to help to make them hard and 
firm, beautiful and useful. We may also do much, in many ways, to 
insure a symmetrical face with harmonizing teeth and jaws, by guard- 
ing against a most natural habit about wmich I wish to caution mothers 
in most emphatic terms ; a habit most natural, and altogether innocent, 
so often formed in infancy, to the gratification of the erring mother, 
until its disastrous influence upon the facial expression of the child has 
become so thoroughly moulded that it is beyond the control of any power 
except that of a skilled specialist to correct, both at the expense of the 
child's comfort and of the parent's money. 

The habit to which I refer is that of thumb-sucking. It may be 
easily understood how a decided change in the formation of the jaws can 
result when any force is brought to bear in an abnormal direction upon 
a structure which is just being built up by the work of cell formation, 
when we think of the possibilities of moving a fully formed tooth, or a 
number of them, in a fully formed jaw ; by the use of the application of 
the most minute but constant force through the agency of special appli- 
ances, for a period of time, they can be moved in any direction required 
almost without limitation. On the contrary, think of the structure of 
an infant's jaw at birth; being composed of two segments from which 
it is developed, these very delicately united, — only by a fibrous symphysis 



536 CARE OF CHILDREN. 

in which ossification is not complete until the end of the first year, which 
is then of only inferior density, as an increasing hardness will still con- 
tinue to manifest itself until the end of maturity. 

It is during the period of developing bone structure that the innocent 
babe contents itself with Nature's time-honored pacifier, thus heaping 
upon itself the foundation for criticism of its beauty and expression, 
while the mother is feasting her mind upon pleasant thoughts of its 
peaceful disposition. 

Not only does this practice in babies affect the jaws, but the teeth 
may be badly displaced, for it is during this time that the tooth follicles 
are at work building up baby's teeth. 

The work of the great Architect must go on, even though interfered 
with in many ways, and if the teeth are blocked from their normal pas- 
sage through the gums they will take some other course, resulting in a 
badly disarranged dental arch. 

Facial deformities are by no means always acquired, as they 
are often a matter of inheritance or undue development of certain por- 
tions of the face, for a child may inherit a distinct irregularity just as 
easily as any other distinctive feature as a primary heredity. Secondarily, 
it may inherit separate peculiarities which combine to cause irregularities 
of the teeth ; for instance, large teeth may be inherited from one parent, 
and small jaws from the other, producing an irregularity of some kind, 
yet not inherited directly from either. Also, as a child may inherit tone 
of voice, peculiar gait or other habit, so he may inherit a habit which 
will cause an irregularity of the teeth. The intermarriage of different 
races might also be given as a cause of indirect heredity of irregularities. 
There are also many local causes for irregularity of teeth, notably 
among which are to be considered, first, too long retention of deciduous 
teeth; second, too early extraction of deciduous teeth; third, injudicious 
extraction of permanent teeth ; fourth, delayed eruption of permanent 
teeth. 

The cause of an abnormally high palate or vault, a narrow upper arch 
with protruding upper and retruding lower teeth, forming what may 
vulgarly be termed a parrot mouth, can be directly traced and easily 
observed by anyone who has ever seen a baby lying in a crib sucking its 
thumb. In this recumbent position, with the palmar portion of the 
thumb (that portion continuous with the palm of the hand) resting firmly 
with a constant force upon this partially developed palate, the dorsal 
portion, or back of the thumb, resting upon the lower lip and chin as a 
fulcrum, the weight of the arm as a lever bringing a constant force to 



TEETHING. 



537 




Fig. 67. Deformity of Teeth caused 
by Thumb Sucking in Childhood. 



bear upon the lower jaw, in a backward direction, causing not only a 
very unsightly deformity to the face but a decided malocclusion of the 
teeth, rendering them almost useless, in many cases, for performing their 
intended work. 

The eruption of the deciduous teeth commences with the central 
incisors from the fifth to the seventh 
month, followed by the lateral incis- 
ors from the seventh to tenth 
month ; then the first molars from the 
twelfth to fourteenth month; then 
the cuspids or canines from the four- 
teenth to twentieth month; and, 
lastly, the second molars from the 
eighteenth to thirty-sixth month. 

This process usually takes place 
in pairs, ,with a slight intermission 

between each class, and, as a rule, the lower teeth are erupted a little 
before the corresponding ones of the upper jaw, due probably to a better 
circulation of blood through the lower jaw than the upper, affording 
more nutrition, thus more vitality to the tissues. The lower cuspids or 
canines, from an old tradition, are popularly called stomach teeth, and 
the upper cuspids called eye teeth, it having been supposed by our fore- 
fathers and mothers that the eruption of these two teeth caused a dis- 
turbance to the stomach in the case of a lower cuspid tooth, and to the 
eyes in the eruption of the upper cuspids. But from the fact that at 
this time very important changes are going on in the whole system, — 
the organs of digestion are beginning to adapt themselves for the diges- 
tion of other food than milk, and because of all these changes there is, 
during this period of dentition, an increasing susceptibility to nervous and 
digestive troubles, requiring more than ordinary watchfulness of the 
child on the part of the mother, and it is perfectly natural that we should 
expect such disturbances. And that because baby is going to cut a 
stomach tooth is no more of a reason why we should expect a disturbance 
in the stomach than if he were going to cut any other tooth, for I have 
seen children in convulsions, caused by the eruption of a molar tooth, 
followed by a severe course of gastro-intestinal trouble. 

An exposure to cold, an attack of indigestion — anything which 
induces discord within the organism — may result in a disturbance in the 
process of dentition, and the reverse may be experienced by the process 
of dentition, often bringing on grave constitutional disturbances, as well 
as to exaggerate any ailment of a child which may exist during this time. 



538 CARE OF CHILDREN. 

As a rule, the severity of the attack is dependent upon the numbei 
of teeth advancing simultaneously, but owing to the varying susceptibil- 
ity of individuals a single tooth may cause more trouble in one case than 
a number of them in another. 

The drooling, or flow of saliva, which accompanies the eruption of 
teeth, is the method Nature has instituted for allaying inflammation by 
keeping the gums moist and cool. 

Heat, redness, swelling, and pain are indications of an advancing 
tooth in the jaw, and are the normal symptoms to be expected during 
teething, and so long as there are no indications of systemic trouble, such 
as high fever, vomiting, diarrhoea, etc., everything will go on safely. 
But when there is a hard, pearly whiteness over the area of the on-coming 
tooth, with dry mouth, and baby very feverish, fretful, and sleepless, 
the gums must be lanced, as failure in this simple operation has often 
resulted in convulsions, which are sometimes fatal, through the severe 
disturbance of the system which is apt to follow them. 

Indications for lancing gums, however, are not always manifested 
locally, and the absence of such indications is by no means always a 
contra-indication to lancing, for without them there may be numerous 
systemic disturbances due entirely to the process of dentition, and 
which may be entirely alleviated by lancing of gums. 

The object of lancing is to divide the gum tissue which binds the 
tooth down, to allow it free egress. Sometimes lancing is necessary for 
partially erupted teeth, as often the cusps having pierced the gum, the 
tooth may be held back by the bands of tissue which draw over 
the surface of the tooth between the cusps, requiring a division of these 
bands to give relief. The relief from lancing usually follows immediately. 

In the case of my own child, who had been feverish and fretful for 
two days, requiring constant care day and night in the arms of either 
my wife or myself, becoming alarmed at advancing systemic disturb- 
ances, I called in a neighboring dentist to assist me in this operation 
(the mother's feelings being of too delicate a nature to witness such a 
procedure), which was accomplished with little inconvenience even to 
the baby, giving immediate relief, as the child was asleep within a half 
hour as quietly as in normal health, remaining asleep for nearly the 
entire afternoon, awakening with normal temperature and appetite. 

By many it has often been urged that in case the tooth does not erupt 
immediately after lancing, cicatricial or granulation tissue is formed over 
the tooth, which will again bind the tooth down, but, as cicatricial tissue 
is of lower organization than normal tissue, it is more easily broken down 



TEETHING. 530 

than before, and would be an argument in favor of, rather than against, 
lancing. 

The lancing should be thoroughly done by either a dentist or physi- 
cian. The lancet should pierce the gum until it grates upon the tooth, 
clearly dividing all overlying tissues, when the pressure will be relieved 
and the trouble probably cease, but should systemic symptoms again 
develop it should be repeated, for it does no harm to be repeated as often 
as is necessary. The pain incident to such an operation is very slight 
and of short duration, as the tightly stretched tissues possess little nerve 
sensation in their superficial layers. In this state of high tension, the 
operation tends rather to relieve than to cause pain. 

Eruption of the teeth occurs just as soon as they are hard enough for 
use, their hardness being dependent upon the amount of lime salts in 
them, as distinguished from purely animal matter, so that in many cases 
where children have not the diet which furnishes these elements, there 
is a consequent retardation of dentition, which by reason of a lack 
of vital force within the system often produces a decided disturbance to 
the system, manifesting itself in a great many ways. 

The gum is absorbed away to make room for the on-coming tooth by 
pressure of the tooth against it. Coincidentally with this process, the 
little capsule which has held the tooth all these months is being con- 
verted into bone to become a socket for the tooth. 

The principal difference between the structure of the temporary and 
that of the permanent teeth is that the temporary teeth contain more 
organic matter, both in pulp contents and in structural make-up, than 
the permanent ones, causing them to be softer and more liable to decay. 
The pulp tissue comes nearer the surface than it does in the perma- 
nent ones, making the work of destruction much easier and more 
rapid upon this vital tissue than in the permanent ones. Consequently, 
their care is more essential than that of the permanent ones, for 
as they have most important functions to perform it is desirable that 
they be retained until their successors shall come in. For not only do 
these little teeth serve the important purpose of mastication during a 
period of rapid growth, but they also assist in the development of the 
jaw during this time, so that their early extraction may decidedly retard 
its development, causing not only a marked influence upon the expression 
of the face, but a very crowded condition of the second teeth as well. 

Considering the serious loss which their absence entails upon the 
workings of the entire economy, temporary teeth should not under any 
circumstances be neglected. They should not be allowed to decay, 



540 CARE OF CHILDREN. 

neither should they be extracted too soon. Under normal conditions 
their roots will become absorbed and their crowns drop out, without the 
assistance of even a string. It seems to be the function of the pulp to 
absorb the roots of a temporary tooth to prevent the pain which would 
otherwise be necessitated by their extraction. 

But if the decay be not arrested in them, it will encroach upon the 
minute nerve fibers which radiate out from the pulp through the struc- 
ture of the dentine, providing in time such an irritation to the pulp tissue 
that it finally dies, defeating the great purpose of Nature to absorb these 
roots, not only subjecting the child to the severest kind of a toothache, 
until a gumboil forms, but leaving the space which is to be occupied by 
the new tooth filled up with the dead roots of the temporary one, causing 
the second tooth to be forced to the one side or the other on its way 
out through the gum. 

This suggests, first of all, cleanliness for their preservation ; inasmuch 
as immunity from decay cannot come locally through any other avenue 
than cleanliness, this necessitates their careful attention from the very 
start. 

Children should be taught, as early as possible, the use of a toothbrush 
after every meal, and until this can be done the cloth washing, at least 
twice daily, should be kept up by the attendant, while the brush should 
be used once in between in order to remove particles which are inaccessible 
by a cloth. The brush used for this purpose should be small, having 
uneven rows of bristles suitable for an adaptation to the spaces between 
the teeth, and should be of a medium harshness, as a brush too soft does 
not stimulate the gums sufficiently, while one that is too harsh will 
irritate them, causing them to bleed. 

It is not sufficient to brush teeth only upon their- outer surfaces. 
They should be brushed up and down and across both inside and out. 

Good toothbrushes are made in abundance, as well as pleasant denti- 
frices, and they are to be used for children as well as for adults. Such 
care as this, providing general health is good, will save the child much 
suffering, and will insure firm, healthy gums and mucous membrane as 
well as hard and pearly teeth to prepare the food for swallowing, so that 
it will be taken into the stomach in good condition to be digested. 

Slow and thorough mastication is one of the requirements for health, 
so we should encourage the child to take a long time for meals ; eat slowly 
and chew thoroughly. Cereals are the best food to supply bone salts, 
but a mixed diet is of a necessity to furnish all the elements required for 



TEETHING. 541 

a growing child, after lie has become old enough to digest solid food — 
we will say from the age of three years. 

The mother should see to the cleansing of baby's teeth and month, 
as no one else would have the interest in it to do it so well as she, and 
a habit of this kind established in childhood will never be forgotten by 
the child. After the child is two or three years of age he should be 
taken three or four times a year to a good dentist to see if perchance, in 
spite of care, there might not be some cavities to be cleansed and properly 
filled. 

Indeed, the importance of filling children's temporary teeth is often 
overlooked by even dentists themselves, as these teeth are supposed to be 
lost so early as to render snch operations unnecessary. But as there are 
remedies known to dental science which have a power to materially retard 
decay when applied upon the surface of a cavity, and which are inexpen- 
sive and productive of great good, there need be no excuse for not taking 
some preventive measures against the decay of children's teeth. 

There are three reasons why temporary teeth should be filled: first, 
to prevent suffering of pain; second, to allow of proper mastication of 
food ; third, to preserve the fullness of the arch for the permanent teeth, 
and with this last object in view I would most emphatically proclaim 
the importance, above all other teeth, of retention and care of the first 
permanent molar, which comes in back of all the baby teeth at about the 
age of six years, and is so often mistaken for a temporary tooth until 
it is far beyond any method of restoration, except by the means of crown- 
ing as a last resort, limiting the usefulness to the average life of a 
crowned tooth, which will only carry the child into young manhood or 
womanhood, when it must be lost, after all the other teeth are in place 
and firmly seated, leaving a space which remains there throughout life. 

The first permanent molar has often been referred to as the keystone 
to the dental arch, as its early extraction causes the malposition of other 
teeth, allowing them to occlude improperly, not only throwing an ad- 
ditional strain upon some of the teeth as well as preventing thorough 
mastication, but often producing a decided change on the facial expres- 
sion by this abnormal occlusion of the upper and lower teeth. 

The teeth should meet each other so as to interlock, as do the cogs of 
a wheel; and it is this condition in the arrangement of our teeth which 
we should seek to attain in their care and management, and it is the 
loss of the first permanent molar which most often disarranges the whole 
occlusion. 

But in case this tooth be innocently neglected until it becomes badly 



542 CARE OF CHILDREN. 

broken down, it would insure a far better future condition to have it 
removed before the tenth year, so the second permanent molar which 
erupts at from the twelfth to fourteenth year will come forward, and 
together with the wisdom tooth, or third molar, fill in the space and show 
a pretty fair complement of teeth at maturity, which will be comparatively 
regular in position. 

In case of children who cannot be brought to a dentist for any reason, 
it is valuable to know that a little carbolized resin applied in the cavity 
of an aching tooth on a pellet of cotton will not only stop a severe 
toothache for the time being but will keep a tooth in a comfortable con- 
dition for weeks, as it hardens in the cavity sufficiently to prevent the 
pressure of mastication from irritating the exposed nerve. 



CATARRH OF THE MOUTH OR CATARRHAL STOMATITIS. 

An inflammation of the lining membrane of the mouth and of the 
tongue. The mucous membrane of the mouth and tongue is red, swollen, 
and coated with a thick slimy mucus. There is considerable pain. The 
disease is common in infants and children. 

Causes. — It is caused by teething, stomach trouble, and certain fevers, 
such as scarlet fever, measles, etc., and the use of foods that are too hot 
or irritating. 

Symptoms. — The mucous membrane of the mouth becomes more or 
less red, dry, and hot. There is some burning and smarting pain and 
an excessive flow of the salivary secretions. The breath is foul; the 
tongue coated ; there is an unpleasant bitter taste in the mouth ; f everish- 
ness; and disturbance of the stomach. The condition lasts for a week, 
sometimes longer. Chronic cases found in adults may be due to the 
abuse of tobacco or alcohol. 

Treatment. — 

Honey, 2 tablespoonfuls. 

Borax, powdered, y 2 dram. 

Mix well together, and take a teaspoonful twice a day. The mixture 
should be placed in the mouth, little by little, touching the various ulcers 
that are visible. 

Or:— 

Chlorate of Potash, 40 grains. 

Tincture of Myrrh, 15 drops. 

Elixir Calisaya, 2 ounces. 



SORE MOUTH. 543 

Mix and take a teaspoonful in a wineglass of water every four 
Iiours, and use as a mouth wash, full strength or diluted. 

Another preparation which is very beneficial is the following; — 

Thymol, 10 grains. 

Borax, 15 grains. 

Water, 2 ounces. 

Mix and put a teaspoonful in a tumblerful of water. Use as a 
mouth wash and gargle frequently. After the attack subsides, tonics 
and a carefully regulated diet may be necessary for some time. 

CANKER OR FOLLICULAR OR APHTHOUS STOMATITIS. 

An inflammation of the follicles in the mucous membrane of the 
mouth and tongue, small vesicles appearing here and there, and, as the 
disease advances, running together forming blister-like patches which 
break and ulcerate. The disease is common in infants and young 
children. 

Causes. — It is due to teething, indigestion, and the fermentation of 
milk in the mouths of nursing babies. It also occurs in the course of 
fevers, such as measles, etc. 

Symptoms. — Redness and small, blister-like eruption on the edges 
of the tongue and the mucous membrane of the cheeks and inside of 
the lips. When these blisters rupture small gray ulcers remain, the flow 
of saliva is increased, the breath is foul, there is some fever and disin- 
clination for food, — not so much due to loss of appetite as to the fact 
that nursing or chewing of food is painful to the irritated membrane. 
Digestion is impaired and there may be diarrhoea. 

Treatment. — Clean out the bowels with a dose of magnesia and 
rhubarb. A solution of ten grains of the sulphate of copper in about 
three teaspoonfuls of water, to which four teaspoonfuls of borax must 
be added, may be applied to the ulcers once or twice daily by means of a 
strong camel's-hair pencil. Solid food, especially salted meats and fish, 
must be rigidly avoided during this complaint. 

The following as a mouth wash is excellent : — 

Peroxide of Hydrogen, 1 ounce. 

Formaldehyde (medicinal), 5 drops. 

Distilled Water, to make 3 ounces. 

Mix and use as a mouth wash three or four times daily. 
Or:— 

Dobell's Solution, which is made as follows : — ■ 



544 CARE OF CHILDREN. 

Sodium Bicarbonate (Baking Soda), i dram. 

Carbolic Acid, 30 grains. 

Glycerine, .• 1 ounce. 

Distilled or Boiled Water, 2 pints. 

Mix and use as a mouth wash frequently. 

If the condition is persistent, quinine sulphate, one-half to one grain 
three times daily, should be administered. 

PUTRID SORE MOUTH OR ULCERATIVE STOMATITIS. 

An inflammation of the mucous membrane and tissues beneath it 
in the mouths of children, beginning on the gums and extending to the 
lips, cheeks, and tongue. 

Causes. — It is caused by unsanitary surroundings and poor food, 
occurring most frequently when the child is cutting teeth. 

Symptoms. — The mucous membrane of the gums becomes swollen, 
boggy, and bleeds readily. White or gray patches appear on them. 
These patches slough off leaving raw ulcers with swollen margins. The 
condition may extend to the lips, cheeks, and tongue, although the tongue 
seldom ulcerates. The mouth is hot and a secretion, a mixture of saliva, 
blood, and broken down tissue, dribbles from the mouth. There is an 
enlargement of the glands beneath the angle of the jaw and the teeth 
may loosen. There is fever, foul breath, disturbance of digestion, and 
diarrhoea. The condition is usually of a week's duration, the ulcerated 
surfaces healing rapidly. 

Treatment. — Administer an elixir, — iron, quinine, and strychnia, — 
one teaspoonful three times daily after meals, for general tonic effect, and 

Formaldehyde (medicinal), 20 drops. 

Camphor Water, 6 ounces. 

Mix. Use as a mouth wash and swab ulcerated spots with a brush 
or absorbent cotton soaked in this solution. 

Or the following powder may be applied to the ulcers : — 

Salicylic Acid, 20 grains. 

Boric Acid, 1 dram. 

Bismuth Sub-Carbonate, 2 drams. 

Apply to the ulcers twice a day with a camel's-hair brush. 

SOOR, MUGUET, SPRUE, WHITE MOUTH, THRUSH, 
OR PARASITIC STOMATITIS. 

Causes. — A disease due to filth and uncleanliness, affecting adults 
but principally bottle-fed children. It may develop from a catarrhal 



SORE MOUTH. 



545 



stomatitis (catarrh of the mouth), and is caused by the development 
of the thrush fungus. It affects adults suffering from cancer or con- 
sumption. In children it is contracted through the bottle, breast, or 
nipple. 

Symptoms. — It begins first upon the tongue, which is dark red with 
whitish points or points that resemble milk curds. These points run 
together forming large patches in which the fungus develops. The 
patches may spread to the lips, cheeks, roof of the mouth, sometimes 
the tonsil and other parts of the throat. The breath is foul and feverish. 
Diarrhcea is sometimes present, the discharges being greenish yellow. 

Treatment. — Strict cleanliness of the mouth and the application of 
borax to the patches, followed at once by a spray or mouth wash of 
peroxide of hydrogen. This causes considerable froth, which is destruc- 
tive to the fungous growth. These applications should be repeated four 
or five times daily. 

Or:— 

Zinc Sulphate, 5 grains. 

Rose Water, 2 ounces. 

Mix. Apply locally and frequently on a cotton swab or with a 
camel's-hair brush. 
Or:— 

Tincture of Iodine, 30 drops. 

Glycerine, ^A drams. 

Mix. Apply once daily. 
In adults: — 

Chlorate of Potash, 30 grains. 

Tincture of Myrrh, 20 drops. 

Elixir Calisaya, to make 3 ounces. 

Mix. Take one teaspoonful in a wineglass of water every three 
hours, and apply the following locally to the ulcers three or four times 
daily : — 

Salicylic Acid, 10 grains. 

Boracic Acid, 3° grains. 

Glycerine, 2 drams, 

Water, to make 2 ounces. 

Mix. 

INFLAMMATION OF THE TONSILS OR TONSILITIS. 

For causes and symptoms, see page 336. 

Treatment.— The patient should be isolated and precautions against 



54 6 CARE OF CHILDREN. 

infection taken; this is necessary as there is so often possibility of a 
mistaken diagnosis in all cases of "sore throat" attended by ulceration. 
There is no certainty that such diseases are not diphtheritic. Indeed, 
the only sure knowledge is to be obtained by microscopic analysis, and 
the finding of the diphtheritic bacilli. 

As very young children are unable to gargle, the treatment will 
consist in making the patient as comfortable as possible and to use 
some local treatment. The disease is self-limited and the prognosis 
is nearly always favorable in children unless other complications arise 
and they are to be met as they present themselves. 

Older children, being able to gargle, may use a solution of : — 

Boric Acid, i teaspoonful. 

Water, i pint. 

Gargle with this occasionally. 

Much benefit often follows the painting of the tonsils with a ten 
per cent solution of^ nitrate of silver or with tincture of iodine carefully 
applied to the tonsils with a camel's-hair brush. 

Where there is a tendency to rheumatism with which tonsilitis 
seems to be in some way closely allied, children of seven years may 
use: — 

Salicylate of Soda, 4 grains. 

Take one such powder every three hours for the first twenty- four 
hours ; after that every six hours. 

It is much better that drugs be not given to young infants. 
Warmth and protection may be afforded to their neck and throat by 
rubbing with camphorated oil and wrapping in cotton batting. Warm 
drinks are valuable in all cases and other ordinary means of inducing 
perspiration may be employed. 

Another valuable gargle for those old enough to use it is : — 

Peroxide of Hydrogen 1 ounce. 

Limewater, 1 ounce. 

To be used as a gargle every two hours. 

Permanent enlargement of the tonsils is very common among chil- 
dren over two years of age. It is the cause of mouth breathing, 
snoring, and of talking through the nose. These are in a measure the 
symptoms of adenoid growths as well; and the two diseases often are 
present at once. The tonsils are frequently so large as to be easily 
felt from the outside of the throat. Difficulty in swallowing food is 
also a common symptom. As the eustachian tubes open into the throat 



QUINSY. 547 

near the tonsils, this enlargement is often a cause of deafness, and the 
inflammation and irritation which the enlargement causes are sometimes 
the causes of ear trouble. The large size of the tonsils not only renders 
the patient susceptible to frequent attacks of tonsilitis but to diphtheria 
as well. 

Treatment. — The removal of the tonsils by surgical" means is the 
most favored treatment. The operation is not a serious one and is not 
attended by much pain or hemorrhage. After the operation liquid 
food is to be taken and a few days' protection from exposure observed. 
Very often it is found convenient to perform the operation for the 
removal of the tonsils (tonsilotomy) and that for the removal of 
adenoid growths at the same time. 



QUINSY OR PERITONSILAR ABSCESS. 

For causes and symptoms, see page 338. 

This is a form of tonsilitis in which suppuration occurs with either 
spontaneous bursting of the abscess or release of the accumulated matter 
through surgical intervention. 

Treatment. — There is always the possibility of aborting the attack 
when the disease is recognized in time. This can sometimes be done 
by giving :— 

Salol, 2 grains. 

Dover's Powder, 34 grain. 

This is to be given to a child of five years every two hours. 

In the earlier stages, before suppuration occurs, cold applications 
bring relief ; after suppuration, hot applications are to be employed. 
The inflammation and pain in the throat may be relieved by giving 
small pieces of ice and by applying the ice bag to the throat. When 
hot applications are needed, water as hot as can be borne is to be used 
as a gargle and hot flaxseed poultices applied externally. In small 
children it is necessary to be very watchful about the time of spon- 
taneous bursting of the abscess as the contents of it may cause choking, 
and, possibly, result in suffocation. 

The ragged edges of the tonsils leave hollow lodging places for 
particles of food and these, by their accumulation and decay, increase 
the risk of contagion from other diseases. It is therefore necessary 
to see that the tonsils are kept as clean as possible during and after 
the attack. 



548 CARE OF CHILDREN. 

VOMITING. 

Not so much a disease in itself as an indication of other forms of 
disease; a very important symptom. 

Causes. — One of the most frequent and least alarming forms of 
vomiting is that caused by overfeeding. This is Nature's way of 
announcing that more food has been taken into the stomach than it 
can accommodate. In this connection it is well to remember that the 
child's stomach is very much smaller than most people are aware of. 
At birth the average capacity of the stomach is one ounce, or about two 
cablespoonfuls ; at two weeks old, two ounces; at three months, four 
and one-half ounces; at six months, six ounces; at one year, nine 
ounces ; and at eighteen months, twelve ounces. Where more food has 
been given than the stomach can hold it is only natural that the excess 
should be returned. The child empties its stomach with much greater 
ease than does an adult. 

Vomiting is always a symptom of acute stomach indigestion; and 
nearly always of acute obstruction of the intestines. It is a usual 
symptom of peritonitis, brain diseases, the infectious diseases, and of 
worms. 

Symptoms. — Vomiting from overfeeding occurs almost imme- 
diately after feeding, and is simply the act of emptying the overfull 
stomach. It is not to be regarded as a sign of illness. 

Vomiting as a result of indigestion does not occur for some time 
after eating. Undigested food is always present in the matter so 
expelled. 

In intestinal obstruction, the matter may contain digested food, 
bile, or, after some days, fecal matter. 

In brain diseases the vomiting is forcible, the matter being sud- 
denly and violently expelled. 

Vomiting after a fall or a blow upon the head is a sign that some 
more or less severe concussion of the brain has occurred. 

Vomiting attending whooping cough is largely mechanical and the 
result of the violence of the spasm. 

Treatment. — This is to be adapted to the cause of the vomiting. 

In overfeeding all that is necessary will be the lessening of the 
amount of food given at a time. 

If the stomach is sour, repeated doses of limewater will be found 
serviceable. 

rlf vomiting is caused by improper food, a little warm water will 
facilitate the expulsion of the offending matter. 



COLIC. 549 

If, after the stomach has been emptied, the vomiting does not cease, 
a few drops of spirits of camphor in a small quantity of milk will 
generally prevent its recurrence. 

COLIC. 

A severe griping pain in the bowels, which often occurs and with 
great severity during the first five or six months of infancy. 

Causes. — Among the most frequent causes are overloading the 
delicate stomach with artificial food; bad milk; the influence of cold; 
and a reflex action from teething. It is a sign of intestinal disturbance 
and may be regarded as an indication of some form of indigestion. 

Symptoms. — In slight attacks the infant suddenly becomes fretful, 
draws up its legs towards the abdomen, whines or cries for a few 
moments, and then resumes its usual quiet condition. After a very 
short interval, another attack of the same kind occurs, and again soon 
subsides ; and this goes on until relief ensues. In many cases, however, 
the symptoms are much more violent : there is excessive and unap- 
peasable screaming, violent kicking, flushing of the face, writhing of 
the body, and a distended and tense state of the abdomen. 

Treatment. — When there is reason for believing that the breast 
milk is unwholesome, a change of diet is necessary. Using a mixture 
of cow's milk and water, or a prepared artificial food, may be tried. 
If the bowels are clogged, magnesia is a good remedy; it is anti-acid 
and purgative. Use three grains of magnesia with two grains of 
powdered valerian. Give twice a day until the acidity of the stomach 
is removed. If this does not keep up a sufficient action of the bowels, 
the proportion of magnesia should be occasionally increased, or a few 
grains of rhubarb added to the powders. 

For lessening the violence and duration of the attacks, the following 
mixture is recommended: Dissolve one dram of camphor in an ounce 
of sulphuric ether; take thirty drops of this solution, twenty grains of 
magnesia, and six drops of laudanum, and mix them together with an 
ounce of fennel seed tea. Of this mixture, a teaspoonful may be given 
to an infant from two to six weeks old; and, if sufficient relief be not 
obtained in half an hour, about half a teaspoonful more should be 
administered. Gentle friction with dry flannel over the abdomen is 
useful in aiding the expulsion of the confined wind. 

Frequently relief is obtained promptly by a rectal injection of one 
or two teaspoonfuls of glycerine in from two to four ounces of cold 
water. 



DD' 



CARE OF CHILDREX. 



The hot water bottle should be placed at the feet and hot applica- 
tions over the abdomen. These should be of a high temperature but so 
placed and protected as not to injure the child. A teaspoonful of hot 
water with or without the addition of a few drops of peppermint, anise, 
gin, brandy, or asafcetida, will prove very comforting and relieve the 
pain. Hot catnip tea, or soda-mint tablets dissolved in hot water, are 
safe and useful temporary means of relieving pain. But no treatment 
is of permanent benefit unless directed towards the cause. 

We must here caution mothers and nurses against the common but 
pernicious practice of administering large doses of anodynes or carmin- 
atives to infants. The habitual use of such substances almost always 
leads to very unfavorable consequences. Under this treatment the 
appetite and digestive powers fail; the body becomes emaciated, and 
the skin sallow and shriveled; the countenance acquires an expression 
of languor and suffering; and a general state of apathy, inactivity. 
and indolence ensues, which will probably terminate in convulsions, 
dropsy of the head, glandular swellings, incurable jaundice, or fatal 
exhaustion of the vital energies. All the usual soothing mixtures con- 
tain more or less opium, and innumerable infants have been irretrievably 
injured by their employment. 

CRAMP IN THE STOMACH OR GASTRALGIA. 

A form of neuralgia which occasions violent pains in the stomach. 

Causes. — The effects of cold, either through exposure, wet feet, 
drinking ice water, and similar causes. It is also a forerunner of acute 
stomach indigestion caused by indiscretions in eating. 

Symptoms. — The symptoms vary from intermittent pain in the 
stomach with no other symptoms, to severe pains which cause prostra- 
tion, cold perspiration, faintness, and marked paleness. 

Treatment. — Put the child to bed and apply a mustard paste or a 
turpentine stupe over the stomach to produce counter-irritation (see 
page 236). Hot drinks may be given consisting of brandy, gin, with 
hot water, and the addition of five drops of spirits of chloroform. If 
the feet are cold apply hot water bottles. Xo food should be given 
until the pain is entirely relieved : after which simple and easily digestible 
food only is to be given. 

ACUTE STOMACH INDIGESTION. 

Causes. — Improper food, which either exacts more work from the 
stomach than it is capable of performing, or is unfit by reason of an 



INDIGESTION. 551 

impaired condition of the stomach. In young children who are fed 
on modified cow's milk the chances are very great that the milk is not 
sufficiently diluted and is too rich in proteids. Very often the disease 
attends weaning when the new food has been given either too suddenly 
or in a strength beyond the child's powers to digest. The sudden 
change from a liquid to a solid diet is another fruitful cause. In older 
children the condition is brought about by overloading the stomach or 
from eating heartily of food which ''does not agree with it." 

Symptoms. — The food remains for a long period in the stomach 
in an undigested state and induces an irritated- condition which is 
relieved by vomiting. The hour after the meal at which the vomiting 
occurs and the degree of digestion that the food has reached in the 
length of time it has been in the stomach, is a clue to the condition of 
the stomach and the severity of the attack. There are always fever and 
high pulse with prostration, which may be very severe in the case of 
young children. The tongue is coated, and very often the stomach is 
filled with accumulated gas which causes distention. The appetite is 
either very poor or entirely gone. 

Prognosis. — This is very favorable, except in the case of very 
young and delicate children, where it so often results fatally. 

With care and rest the disease usually passes off in a few days. 

Treatment. — The food which is the cause of the irritation must be 
at once removed. This is done in the case of verv voungf children by 
washing out the stomach, or by giving the child a quantity of luke- 
warm water to drink from its bottle. This latter acts as an emetic. 
Older children may be given an emetic of mustard and water or similar 
simple means of emptying the stomach. After the stomach has been 
emptied the great thing is rest and quietness. No food should be given 
for four hours. Then the greatest care must be exercised in the choice 
of food. For the next twenty-four hours only barley water in very 
small portions is to be given; then beef juice and broth. After three 
or four days milk may be tried, but it must be very much diluted or, 
better, peptonized. There is very great danger in beginning the use of 
hearty food or of large quantities of food too soon. Even a nursing 
child must return to the breast very gradually and carefully. In such 
cases withhold the breast entirely for twenty-four hours, during which 
time the child takes very small portions of weak barley water. Then 
the child is placed at the breast for only two minutes every three hours. 
After a time the length of nursing is extended very gradually to three, 
four, and five minutes, and lengthened as improvement is seen. 



552 CARE OF CHILDREN. 

If this condition is neglected the case will probably run into one 
of acute inflammation of the stomach, or that in turn to chronic inflam- 
mation. They differ only in degree and in the difficulty of managing 
the diet so as to restore the condition of the stomach. 

DIARRHOEA. 

Diarrhoea is more common during infancy than at any other period 
of life ; and it is more likely to assume an unmanageable and dangerous 
character at this time than at a more advanced stage of childhood or in 
adult life. 

Causes. — The exciting causes of this disease are extremely various. 
Irritating, crude, and inappropriate articles of food and drink are a fre- 
quent cause of diarrhoea. Children who are entirely nourished at the 
breast are much less liable to this complaint than are those nourished by 
artificial food. Some infants are invariably purged when fed on cow's 
milk, even when considerably diluted with water. Infants who are fed 
with solid food are still less likely to escape suffering more or less diar- 
rhoea. The practice of allowing a child to eat potatoes, meat, pastry, 
dried fruit, and similar food is particularly injurious, and often produces 
chronic diarrhoea. Intense summer heat is often an important factor in 
producing this complaint, and the occurrence of bowel complaints among 
children is much more frequent during the hot season than at any other 
time of the year. 

Treatment. — Give a purgative dose of castor oil, laxol, or syrup of 
rhubarb, or a powder containing: — 

Calomel, i-io grain. 

Bicarbonate of Soda, i grain. 

Give one such powder every half hour until the child has taken eight 
or ten. Three hours after taking the last powder give a teaspoonful of 
castor oil. 

Usually this treatment will suffice to arrest the diarrhoea. It is 
advisable to withhold all food except albumin water, barley or rice water, 
whey, mineral water, or cold boiled water for the first twenty-four or 
thirty-six hours. To prevent return of the diarrhoea nourish carefully 
and change the food if necessary. 

If the diarrhoea has existed for some time this bowel cleansing treat- 
ment may not be required, but the following may be used : — 

Dover's Powder, ]/ 2 to i grain. 

Subnitrate of Bismuth, 5 grains. 



CHOLERA INFANTUM. 553 

Give one such powder every three or four hours. 
Rotch recommends the following combinations : — 

Subnitrate of Bismuth, 2 drams. 

Salol, 16 grains. 

Cinnamon Water, 1 ounce. 

Water, to make 2 ounces. 

Mix, shake well, and give a teaspoonful in water every two hours. 
Or, when the stools are green in infantile diarrhoea : — 

Calomel, 1 grain. 

Ipecac Powder, 1 grain. 

Milk Sugar, 20 grains. 

Mix and divide into ten powders and give one powder three times 
a day. 

The following is highly recommended : — 

Tannalbin, 2 drams. 

Brandy, 2 drams. 

Simple Syrup, 4 drams. 

Water to make 2 ounces. 

Give a tablespoonful four to six times a day. 

In the summer diarrhoeas of children where there is vomiting and 
the causes are heat and improper feeding, give the following after the 
purgative doses first mentioned have operated: — 

Calomel, 1 grain. 

Phosphate of Soda, 30 grains. 

Ipecac Powder, y 2 grain. 

Milk Sugar, 20 grains. 

Mix and divide into ten powders and give one every half hour. 

If the child is much prostrated give five or ten drops of brandy 
frequently. The fever is to be controlled by sponging the body with 
tepid water and alcohol. 

Castor oil is best administered in doses of one dram in hot milk. 
An enema of warm water for a child of six months should consist of 
one pint. It is often more convenient than a purging dose. 

SUMMER COMPLAINT OR CHOLERA INFANTUM. 

An acute disease occurring among infants and young children 
during the hot weather of summer. 

Causes. — A micro-organism usually conveyed in milk ; faulty nutri- 
tion of the child; sour milk; fermenting food; teething; and cold. It 
is most common between the ages of three months and two years. 



554 CARE OF CHILDREN. 

Symptoms. — It usually begins with vomiting and purging about the 
same time. The tongue in most cases is slightly furred at the begin- 
ning of the disease; but, after a few days, it becomes dry and brown. 
The stools are commonly fluid, intermixed with little spots of green 
bile; or they are as transparent as water; or are of the "rice-water" 
appearance. The patient is immediately prostrate, and emaciates very 
rapidly. The vomiting and purging are not always constant, but some- 
times occur in paroxysms at intervals of five or six hours. In some 
fortunate cases they subside entirely after a duration of five or six 
hours. There is evident pain or great uneasiness in the bowels and 
stomach. The hands and feet are cold, the skin of the body and head 
is hot and dry, and becomes shriveled. In this condition the child 
lies upon the lap or upon the pillow, apparently exhausted and indis- 
posed to move, except when impelled to vomit or to cry for water, — 
the only thing which it is willing to take,— and this is often thrown up 
instantly from the stomach or suddenly passed off by the bowels. The 
eyes lose their luster, the eyelids but half cover them, the nose becomes 
pointed, the skin contracted upon it, while the lips are thin and 
shriveled. 

Prognosis. — The disease runs a short, acute course. Exhaustion 
is very pronounced. Convulsions and death may take place in from 
a few hours to two or three days. Complications, such as inflammation 
of the kidneys, pneumonia, etc., frequently follow the attack. Con- 
valescence is slow and relapses are quite common. 

Treatment. — On the first appearance of the disease, if possible, 
take the child to the open air of a farm or small village. A well 
ventilated apartment in the upper story of a house, if not too much 
heated by the roof, will give a child a much better chance for life than 
the ground floor. 

The house should be clean and well aired; as a preventive of this 
disease children should be well washed daily with tepid or cool water, 
their dress is to be changed sufficiently often to insure cleanliness; 
nursing mothers are to abstain from eating unripe or unwholesome 
food, and children must be prevented from having it. The child should 
wear flannel next to its skin and worsted stockings on its feet even in 
the summer season ; and when it has passed beyond its first year, the 
diet is to be strictly regulated upon the principles laid down elsewhere. 

At the onset of the disease give calomel in one-fourth of a grain 
dose every hour for eight or ten doses, or until bile appears in the 
stools. Then give a dose of castor oil of one teaspoonful in hot milk. 



CROUP. 555 

Keep up the body heat by the use of hot water bottles, mustard baths, 
two or three times a day, Stimulate and quench the thirst with ten 
drops of brandy given in rice water or barley water every hour or two. 
At the same time give an enema of a teaspoonful of table salt in a pint 
of warm water to wash out the bowels. 

To control the vomiting, to stop fermentation, and to arrest the 
movement of the bowels give : — 

Subnitrate of Bismuth, 2 drams. 

Carbolic Acid, 1 grain. 

Syrup of Ginger 4 drams. 

Peppermint Water, to make 2 ounces. 

Give a teaspoonful every one or two hours. 

Or:— . 

Tannalbin, 80 grains. 

Powdered Opium, 1 grain. 

Aromatic Powder, 2 grains. 

Milk Sugar, 20 grains. 

Divide into twenty-four powders and to a six months old child 
give one every four or six hours. 

A child one year old will take two powders at a time every four 
or six hours. 

Grease the skin over the stomach and bowels with vaseline or oil 
and then apply cloths wrung out of hot water and sprinkled with 
turpentine. 

Or apply mustard pastes over the stomach and bowels. 

CROUP. 

Inflammation of the larynx and trachea, characterized by difficult 
breathing and a rough, hoarse cough sounding as if air was passing 
through a metallic tube. It usually attacks children of from one to 
three years of age. 

Symptoms. — The symptoms are at first those of a common cold, 
or catarrh ; then comes a dry cough, with hoarseness and wheezing ; at 
night there is restlessness, and rattling is heard in the throat; after 
which the croupy crow and sound above spoken of give unmistakable 
warning of the disease. The child, after tossing about restlessly, starts 
up with a flushed face, and a distressing look of terror and anxiety; 
there is a quick pulse, and agitation of the whole frame, which soon 
becomes covered with a profuse perspiration. As the struggle for 



556 CARE OF CHILDREN. 

breath proceeds, there is clutching at the throat, as though to force a 
passage; the arms are thrown wildly about, the respiration becomes 
more labored, the rough cough more frequent and characteristic. 
There is expectoration of viscid matter; strangulation threatens; and 
eventually the child falls into the sleep of exhaustion. It will wake up 
probably refreshed, and during the day may appear to be pretty well; 
but at night there will be a recurrence of the attack with aggravated 
symptoms, convulsions, and spasms of the glottis. The face is of a 
pale leaden hue; a film comes over the eyes: the pulse is feeble; the 
powers of life at length succumb and the patient sinks into a drowsy 
stupor, which ends in death. Such is the frequent course of this painful 
disease, and the changes from bad to worse are so rapid that there is 
little time for the operation of remedies. 

Treatment. — Confinement to the house when croup threatens is 
always advisable, unless the weather be open and warm. Apply mus- 
tard pastes to the throat. Fill the room with the vapor of boiling 
water, — a large kettle on the stove will effect this, — or the vapor from 
slaked, freshly burned lime. A physician should in all cases be sum- 
moned immediately. Most cases of croup are really cases of laryngeal 
diphtheria and only a very small percentage is due to causes other than 
diphtheritic infection. If the condition prove to be diphtheritic there 
is the greater need of a physician. In true croup, not diphtheritic, 
while awaiting the arrival of the physician give a teaspoonful of the 
syrup of ipecac every ten or fifteen minutes until vomiting is induced. 
Free vomiting relieves the spasms but does not prevent a recurrence of 
them. Wine of ipecac, in 20-drop doses every ten minutes, will also 
produce the same effect. 

Or:— 

Turpeth Mineral, 2 grains. 

This dose for children two years old is to be repeated in twenty 
minutes or until vomiting occurs. 

Should the child appear likely to sink from exhaustion, after vomit- 
ing has been brought about, stop the emetics and give : — 

Solution of Acetate of Ammonia, 20 drops. 

Or, give twenty drops of brandy, or of camphor mixture. 

It is said that the formation of the membrane may be stopped by : — 

Sulphate of Quinine, 1 grain. 

Calomel, 1-10 grain. 

Give one such dose three or four times a day. 



WORMS. 557 

WORMS. 

Worms are parasites which infest the intestinal canal of children 
principally. 

Symptoms. — Fetid breath, grinding of the teeth during sleep, 
picking the nose, paleness of the face, irritableness, and itching of the 
lower parts of the body. 

Round or Stomach Worm. — The best remedy is santonin ; the usual 
method is to give it in a powder combined with the same amount of 
calomel, and a little pulverized sugar added. One grain of santonin 
and one of calomel would be sufficient for a child three years old. 

One-sixteenth to one-fourth of a grain of podophyllin may be sub- 
stituted for the calomel, given in syrup or molasses, or the santonin 
given alone can be followed with a dose of oil ; there is no better method 
of expelling stomach worms. Santonin colors the urine, and may 
produce nervous symptoms, hence give only one powder each night and 
morning for two days, follow with a mild purge if needed, wait two 
days, and administer again in the same way. 

Tape Worm, least common of the usual varieties, is the most 
troublesome and difficult to remove on account of a strong hold by little 
hooks upon the mucous coat of the intestines. Before giving medicine 
to expel a tapeworm, preparatory treatment should be used as follows : 
The diet should be light for two days, and the bowels cleansed of mucus 
by physic. Medicine to remove the entire worm must be efficient. 
The following harmless treatment can be used : After a day or two of 
fasting, take two ounces of pumpkin seed, remove the outside husks, 
beat fine, add a little sugar and water, and drink the whole at once. 
One hour and a half later take an ounce of castor oil. The following, 
though not as simple, is efficient: — ■ 

Croton oil, i drop. 

Chloroform, i dram. 

Glycerine, i ounce. 

Mix thoroughly. Take in the morning, omitting food; this acts 
promptly. 

Thread or Seat Worm. — Proceed precisely as for round worms, 
which will remove them, but as they multiply from eggs deposited in 
the folds about the rectal orifice, it is necessary to inject a decoction of 
quassia, or apply carbolized vaseline, for several nights, to prevent their 
further multiplication ; the strength of the carbolic salve is : — 



558 CARE OF CHILDREN. 

Carbolic Acid, 15 grains. 

Vaseline, 1 ounce. 

Mix thoroughly and apply faithfully. 

SPASM OF THE GLOTTIS OR CHILD CROWING. 

This exhibits much the same symptoms as croup. It is not, how- 
ever, of an inflammatory character, but is commonly symptomatic of some 
other disease coming on, as a result of irritation caused by hydro- 
cephalus, teething, worms, etc. The medical man only can judge of 
the probable cause, and he will use such remedies as are most applicable 
to the peculiarity of each case. 

Treatment. — The following mode of treatment is recommended: 
A sponge about the size of a large fist, dipped in hot water, squeezed 
half dry, and applied instantly under the little sufferer's chin over the 
larynx and windpipe; a second sponge, heated in the same way, should 
be used alternately with the first. A perseverance in this plan during 
ten to twenty minutes produces a vivid redness over the whole front of 
the throat, just as if a strong sinapism had been applied. In the mean- 
time the whole system feels the influence of the treatment; a warm 
perspiration breaks out, which should be well encouraged by warm 
drinks, and a notable diminution takes place in the frequency and time 
of the cough, while. the hoarseness almost disappears, and the rough, 
ringing sound of the voice subsides, along with the difficulty of breath- 
ing and restlessness; in short, all danger is over, and the little patient 
again falls asleep, and awakes in the morning without any appearance 
of having suffered from so dangerous an attack. This disease has been 
repeatedly treated on this plan, and with the most uniform success. It 
is, however, only applicable to the very onset of the disease ; but it has 
the advantage of being simple, efficient, and easily put in practice, 
and its effects are not productive of the least injury to the constitution. 

SNUFFLES OR COLD IN THE HEAD. 

Children are very liable to this distressing complaint, caused by 
inflammation of the lining of the nose. 

Treatment. — Rubbing the nose with camphorated oil, goose grease, 
lard, or tallow will generally give relief. Keep the bowels open with a 
little castor oil; and, if the stoppage in the nose is obstinate, give warm 
doses of catnip, pennyroyal, or balm tea. 



MENINGITIS. • 559 

CONVULSIONS, FITS, AtfD SPASMS. 

These are the result of some form of irritation acting upon the brain 
and nervous system. 

Treatment. — Domestic treatment should never be trusted in such 
cases. Not a moment should be lost in sending for a physician. 

If anything can be done in the meantime, it is, to evacuate the 
bowels by warm water injection, made more active by the addition of 
castile soap and a pinch of salt, and to administer the warm mustard 
bath. An important point, never to be forgotten in the hurry of these 
cases, is to preserve the stools for inspection, otherwise the physician 
will be deprived of a very important source of judgment. 

In cases of fits arising plainly from exhaustion, there need be no 
hesitation in giving five drops of sal volatile in water. It is necessary 
to maintain self-possession. 

In all cases, clear the bowels by means of the slow injection of from 
a quarter to half a pint of warm soapsuds. 



INFECTIOUS DISEASES OF CHILDREN. 

CEREBRO-SPINAL FEVER OR CEREBRO-SPINAL 
MENINGITIS. 

A malignant epidemic fever. 

Causes. — A micro-organism, the Diplococcus intraceUularis, which 
is supposed to affect the brain by entrance through the nose. Bad 
hygiene; exposure; winter season; and youth are the chief predisposing 
causes. It affects populations in cities almost entirely, where it appears 
at long intervals in the form of an epidemic; then it disappears mys- 
teriously and little is known of it for some years. 

Symptoms. — Chill ; intense headache ; dizziness ; vomiting ; and 
great weakness. Very early the muscles of the neck become set and the 
head is drawn back; the muscles of the back are similarly affected and 
the body is bent or arched back. Cramps; convulsions; delirium; 
inflammation of the joints; extreme sensitiveness to light and 
sound; then follow deafness; blindness; loss of the special senses; 
paralysis of the muscles of the eye; there is also great emaciation. 
Drawing the nail across the abdomen leaves a red streak characteristic 
of affections of the brain. This condition lasts for from a few hours to 
several weeks. The usual crisis of the disease is reached in from three 



5 6o CARE OF CHILDREN. 

to eight days; it is followed either by death or a long and tedious con- 
valescence. 

Prognosis. — The mortality reaches from 20 to 75 per cent. On 
recovery there may be constant headache ; gastric disturbance ; blindness ; 
deafness; mental feebleness; epilepsy; and palsy. 

Treatment. — The chief means of relief are afforded by puncture 
in the lumbar region of the back to withdraw one or two ounces of the 
fluid early in the attack. This relieves the coma and insensibility, and 
doubtless saves many cases. The other treatment is of the symptoms as 
they occur and to support the strength and resistance of the patient. A 
liquid diet of as nourishing food as possible is given. When this can- 
not be taken or retained, it must be administered by rectal feeding. (See 
page 250.) Pain, delirium, convulsions, and sleeplessness are relieved 
by the use of narcotics. A weak, rapid, and irregular pulse indicates the 
necessity of stimulants to prevent collapse. Bedsores are common. (For 
their prevention and management, see page 228.) 

WHOOPING COUGH OR PERTUSSIS. 

A contagious disease, marked by a paroxysmal cough, most largely 
affecting young children. 

Cause. — A micro-organism communicated by mere proximity and 
even in the open air. It is the most contagious disease to which young 
infants may be exposed. Fully one-half the cases are among children 
less than two years of age. 

Symptoms. — Three stages are recognized: the catarrhal, the spas- 
modic, and the period of decline. 

During the catarrhal stage there are symptoms of ordinary bron- 
chitis : the watery eye ; running at the nose ; and some slight fever. 
This usually lasts for eight or ten days. Towards the latter part of this 
period the cough increases in intensity and there may be three or more 
daily attacks before the "whoop" is heard. 

The spasmodic stage begins with the peculiar cough from which the 
disease takes its name. That is the first confirming symptom of the 
disease. Up to that time the nature of the disease may not be suspected. 
The child may give a few short coughs, ending with the "whoop," and 
the expulsion of thick, stringy mucus, and sometimes with vomiting. 
During a paroxysm the face is swollen and red, becoming purple; the 
eyes protrude; nosebleed is quite common; the spasm may last for two 
or three minutes, during which half a dozen "whoops" may occur. 



WHOOPING COUGH. 561 

When the spasm comes just after a meal and is accompanied by vomit- 
ing, the child may suffer from lack of nutrition. After an attack the 
child can barely stand; perspiration is profuse; and the child appears 
dazed. The sensation of suffocation causes intense suffering; artificial 
respiration is sometimes necessary to relieve infants from impending 
asphyxia. The number of spasms which occur in twenty-four hours 
varies from six to fifty. They are always more frequent at night than 
in the daytime ; and in a close room, than in the open air. This stage 
runs on an average about one month. There are cases of such mildness 
that it may continue for only a week ; others again, in winter, often last 
for three months. 

The third stage, or period of decline of the symptoms, is marked by 
a gradual decline of the severity of the symptoms; the "whoop" stops; 
and the cough grows more and more like that of ordinary bronchitis. 
Generally this lasts for about three weeks; but there is danger of a 
longer continuance of it during the winter, and the cough may be pro- 
longed by habit, which is very strong in some children. 

Prognosis. — During infancy and the first year there is, perhaps, no 
disease to be more dreaded; in this period of life there is such great 
danger of complications of pneumonia, diarrhoea, and convulsions. 
Two-thirds of the total number of deaths from whooping cough occur 
in the first two years of life. It is very rare that fatal cases are known 
after the fourth year. The paroxysm, while terrifying to parents, is 
very rarely the cause of death. A few such cases are known. One 
great danger that this disease shares with measles is the predisposing 
influence to consumption. 

Treatment. — The great need, and in the majority of cases the only 
need, is care in the hygienic surroundings of the patient. Good nursing 
and watchfulness are important essentials. Protection against cold and 
abundance of fresh air will pull most of the cases through. The benefit 
of good air is seen in the fact that the paroxysms are fewer and 
occur at longer intervals with less severity while the patient is in the 
open air. In the case of very young children great caution must be 
exercised in outdoor treatment. Care must be taken with the food of 
young children, as there is danger of intestinal indigestion and other 
disturbances. When vomiting occurs, it will often be necessary to 
repeat a meal in order to properly nourish a child. Digestion disturb- 
ances increase the severity and the frequency of the spasms. Inhala- 
tions of eucalyptol or creosote are valuable. Dr. Holt advises the use 
of antipyrine in one grain hourly doses for a child of one year; for a 



562 CARE OF CHILDREN. 

child two years old, two grains repeated every four or six hours. But 
antipyrine should not be used if pneumonia threatens. 
A child of one year may take: — 

Extract of Belladonna, I grain. 

Alum, y 2 dram. 

Syrup of Ginger, i ounce. 

Syrup of Acacia, i ounce. 

Water, i ounce. 

A teaspoonful every six hours. 

The following treatment has proved of great value : — 

Bromide of Sodium, 24 grains. 

Antipyrine, 8 grains. 

Syrup of Ipecac, 32 drops. 

Water to make, 1 ounce. 

One teaspoonful every two hours for three or four days to a child 
of two years. Then give instead three grains of sulphate of quinine every 
three hours for three or four days. Then return to the mixture of 
sodium bromide, antipyrine, and ipecac, every two hours for three or 
four days, and so on until the whooping cough subsides. In order to 
insure ample protection from draughts, there may be applied a snugly 
fitting jacket of cotton batting extending from the armpits to the hips 
and covered with oiled silk. 

In cases of exposure of young children or delicate patients and risk 
of cold Dr. Hare recommends a bronchitis tent under which the child 
may rest day and night. It is made by fastening a sheet to four upright 
sticks placed one at each corner of the bed. Broomsticks or poles may 
be used in its construction, and it may be decorated to make it attractive 
to the patient. The steam from a teakettle kept constantly boiling at 
the foot of the bed may be led into the tent and the water may be 
medicated. This is very useful in rooms that are unevenly heated, with 
cold floors, or when dry furnace heat is used. 

MUMPS OR PAROTIDITIS. 

An acute, infectious inflammation of one or both of the parotid 
glands, with or without swelling of the salivary glands and the neighbor- 
ing tissue. 

Cause. — It is caused by a specific poison which can be com- 
municated from one person to another by contact, or may be carried in 
clothing. It more commonly attacks males than females, and is most 



SCARLET FEVER. 563 

common between the ages of five years and of puberty. One attack 
generally, but not always, renders a person immune. 

Symptoms. — The chief symptom besides the swelling of the glands 
is pain in the parotid region, at the angles of the jaw. This pain is 
greatly increased on attempting to move the jaw. There is fever to a 
moderate degree; marked swelling of the side of the face. The swell- 
ing subsides in about one week, when there is recovery or, more fre- 
quently, an attack on the other side. The breasts of females and the 
testes of males are often involved in inflammation. Orchitis is the name 
applied to the latter condition. 

Prognosis. — In mild cases the termination is always favorable; 
but with complications the disease is more serious. 

Treatment. — Liquid diet is compulsory, owing to the difficulty of 
moving the jaw without pain and the inability to masticate solids. 
Sour foods and drinks increase the pain by exciting the flow of saliva. 
If the fever is high, 3-drop doses of tincture of aconite may be given. 
If pain is severe, hot fomentations may be applied. If the testicles are 
involved, aconite may be given with potassium citrate as follows : 

Tincture of Aconite Root, 1 to 3 drops. 

Sweet Spirits of Niter, 10 to 15 drops. 

Solution of Potassium Citrate, to make 1 dram. 

Take one such dose every three hours. 

The following is an effective liniment for application to the neck and 
throat; especially if the swelling suddenly disappears and the fever 
becomes high : — 

Camphorated Spirits, 1 ounce. 

Solution of Subcarbonate of Ammonia 2 drams. 

Tincture of Cantharides, Yi dram. 

Continue to apply, rubbing well in, until the swelling reappears. 
Ointments of belladonna, guaiacol, and mercury, either separately 
or in combination, may be applied with advantage. 

SCARLET FEVER OR SCARLATINA. 

Causes. — A micro-organism which, so far, has not been clearly de- 
fined. It is known to be of very great vitality, and the disease is com- 
municated by the skin, which peels off in the process known as desquama- 
tion. The poison is conveyed into the body by the respiratory organs 
and by food. It principally attacks children under fifteen years of age. 
While second attacks are known they are uncommon. 



564 CARE OF CHILDREN. 

Symptoms. — There is usually a scarlet rash on the second day of 
illness, accompanied by marked fever symptoms. The outbreak is sud- 
den. There is a chill; vomiting or convulsions; fever of 105 °, and pulse 
from no to 140 beats per minute. The rash is bright scarlet and soon 
spreads over the entire body. The eruption is level with the surface of the 
skin and disappears on pressure. After the rash has remained for a period 
of from five to seven days it disappears, and the process of desquamation 
or peeling of the skin begins. Sore throat then begins and is of an acute 
catarrhal inflammatory nature with swelling of the glands and tonsils. 
Swallowing is difficult; the tongue, at first furred, soon assumes the 
"strawberry tongue" characteristic of scarlet fever. The simple cases 
of the disease last for from three to thirteen days. 

Prognosis. — But the danger is not then over; for, besides the com- 
plications of the disease period, there are many serious possibilities in 
this direction during the slow and tedious period of convalescence. The 
fatality is from five to thirty per cent, according to the severity of the 
disease and the presence of complications. 

Treatment. — Isolation and strict enforcement of the preventive 
measures described on page 1 54. The bowels are to be opened by : — 

Calomel, 1-10 to % grain. 

Bicarbonate of Soda, 1 grain. 

Make ten such powders and take one every half hour, or until the 
bowels move freely. 

The fever is to be reduced by cold bath, cold douche, cold sponging 
or cold pack, as detailed on page 256. At the same time the following 
fever mixture may be given with great benefit: — 

Acetate of Potash, 4 drams. 

Sweet Spirits of Niter, 1 ounce. 

Water enough to make, 4 ounces. 

Give one teaspoonful, well diluted in water, every two or three 
hours. 

Headache is relieved by application of the ice bag. 

As soon as the rash appears the body should be anointed with 
cocoa butter, or cold cream, or: — 

Eucalyptol, 1 dram. 

Carbolized Vaseline, 1 ounce. 

Mix and apply lightly. This is not only to allay the itching which 
occurs, but also to prevent the flying about of the particles of skin by 
which the disease is communicated, 



MEASLES. 565 

Rest in bed and liquid diet are to be enjoined. 

For sore throat use Dobell's solution as a spray. 

A good gargle to be used every hour in such cases is : — 

Thymol, 4 grains. 

Glycerine, 1 ounce. 

Water, 1 ounce. 

Where the attack is malignant, stimulation is necessary. 

Acute Bright's disease of the kidney (acute nephritis) is a common 
complication after the peeling has begun in the second and succeeding 
weeks. 

Scarlatinal inflammation of the joints may be benefited by : — 

Salicylate of Ammonia, 2 drams. 

Simple Elixir, ]/ 2 ounce. 

Simple Syrup, 1 ounce. 

Compound Tincture of Cardamom, y 2 ounce. 

Take a teaspoonful in water four times a day. 

In inflammation of the ear (otitis), syringe the ear with hot water 
or apply the hot water bottle. 

MEASLES OR RUBEOLA. 

Cause. — A micro-organism about which, as yet, little is definitely 
known. It is usually communicated by clothing and attacks children 
generally and occasionally adults. It generally occurs as an epidemic, 
although single cases are frequently met with. First attacks commonly 
render the subject immune. 

Symptoms. — The first symptom is usually an attack of what appears 
to be a common cold in the head (coryza). A chill may or may not 
accompany it. Then comes fever of about 101 or 102 . Headache, 
soreness in the muscles, inflamed and watery eyes, great sensitiveness 
to light, coughing and sneezing quickly follow. The fever subsides 
on the second day, is absent on the third, and reappears on the fourth. 
Then appears a group of small, dark-red eruptions on the face and 
later over the entire body. Itching and burning attend the eruption, 
which begins to disappear about the ninth day. The spots go away 
in a sort of bran-like flaking of the skin. 

Black measles is the name given to that form which is marked by 
very dark colored eruption due to the presence of a form of hemorrhage 
and in which the patient is prostrated. It is met with in jails, camps, 
and Unsanitary dwellings. 



566 CARE OF CHILDREN. 

Prognosis. — When not complicated the disease is not at all fatal. 
Attendant lung troubles make the case more serious. Black measles 
are more generally fatal. 

Treatment. — Disinfection and preventive measures must be care- 
fully observed as described on page 154= The patient must be iso- 
lated ; put to rest in bed ; the room must be comfortably warm, free from 
draughts, and well ventilated. 

Keep the bowels open by the use of Hunyadi Janos water, Apenta 
water, Seidlitz powder before breakfast, or other mild laxative. The diet 
is semisolid as described on page 2*7. Xo medicine is needed in mild 
cases. If the fever is high it may be reduced by cold sponging, or alcohol 
rub, as on page 251. This fever mixture may be given: — 

Tincture of Aconite Root, J / 2 to 1 drop. 

Sweet Spirits of Niter, 10 to 15 drops. 

Solution of Citrate of Potash to make, 1 dram. 

Take one such dose every two hours. 
Itching is relieved as in scarlet fever (page 564.) 
For the inflamed, catarrhal condition of the nose and throat the fol- 
lowing is very good: — 

Creosote, 2 drams. 

Oil of Eucalyptus, 6 drams. 

Put 30 drops of this in a pint of boiling water and let it vaporize 
over a lamp or stove, so that the patient may inhale it. In addition, one or 
two teaspoonfuls of Brown Mixture every two or three hours is beneficial. 

For treatment of children the following may be used : — 

Codeine Sulphate, 2 grains. 

Syrup of Ipecac 1 dram. 

Syrup of Wild Cherry, 1 ounce. 

Camphor Water enough to make, 3 ounces. 

For children of four or five years, give y 2 teaspoonful. 

For children two to four years, give J4 teaspoonful. 

For children of six years or over, give 1 teaspoonful. 

Let it be taken every two or three hours. 

During convalescence give syrup of iodide of iron in from 10 to 
30 drop doses in a little water three times a day. Cod-liver oil is also 
of great service. 

GERMAN MEASLES OR RUBELLA. 

Causes. — A micro-organism not yet well known. It is often an 
epidemic disease, although single cases frequently occur. The con- 



DIPHTHERIA. 567 

tagion like that of measles is carried in clothing. It is most common 
in childhood and one attack generally renders the subject immune. 

Symptoms. — The attack is sudden with a mild fever. The eyes are 
watery to a slight degree, but there is little or no cold in the head. 
The throat is sore and the glands of the neck swell. At any time from 
the first to the fourth day a rose-colored eruption of spots of pinhead 
size appears. 

The disease usually lasts a week. Recovery is almost universal. 

Treatment. — Generally no treatment is required. In aggravated 
cases, where any treatment may be thought necessary, that of measles is 
sufficient. (See "Measles," page 565.) 



DIPHTHERIA OR PUTRID SORE THROAT. 

Cause. — The micro-organism known as the Klebs-Loeffler bacillus 
or the Bacillus diphtherial This bacillus in its growth produces a poison- 
ous material which is absorbed into the body and causes the disease. 
There is a great deal of confusion caused by the use of the word diphthe- 
ritic in naming diseases. It is not diphtheria unless the bacillus men- 
tioned is present, no matter how closely the so-called disease may 
resemble diphtheria. Bad hygiene increases the severity of the attack 
and causes it to spread more extensively. It is eminently contagious 
and is carried by clothing, and the virus floats in the air to a considerable 
distance. It develops in from three to five days from the time of 
exposure. 

Symptoms. — The form and severity of the symptoms vary consid- 
erably in different cases. An attack which ultimately proves to be very 
serious may come on with the mildest form of symptoms. There are 
chill; fever up to 105 ; headache; listlessness ; loss of appetite; stiff neck; 
pain in the angle of the jaw and in the ear; sore throat; aching limbs; 
difficulty in swallowing; prostration and weakness. The throat is usu- 
ally the seat of the disease. There is an effort to clear the throat by 
hawking; there are redness and swelling in the throat; a dirty-white 
membrane forms on the sides and sometimes on the uvula; when this 
membrane is removed there shows a raw, bleeding surface upon which 
the membrane soon forms again; the tonsils are often spotted with the 
membrane ; the breath becomes offensive and the glands of the neck swell. 
The nose is often affected by the discharge; and nosebleeding is fre- 
quent. When the disease affects the larynx there is hoarseness or loss 
of voice, a croupy cough, and difficulty in breathing. The disease lasts 



568 CARE OF CHILDREN. 

from two days to a fortnight; complications may extend this time 
indefinitely and relapses must be watched for. 

Complications and After-effects. — There may be eruptions on the 
skin, which, while not dangerous in themselves, may lead to a wrong 
diagnosis of the disease. 

Inflammation of the kidneys (nephritis) with accompanying increase 
of albumin in the urine (albuminuria) is the most common complication. 

Broncho-pneumonia is very common and one of the most dangerous. 
Inflammation of the lining membrane of the heart (endocarditis) and 
inflammation of the joints (arthritis) are often seen. The patients are 
often left in an anaemic condition. Paralysis as a result of the distribu- 
tion of the poison of the bacillus through the system occurs in from 
10 to 20 per cent of the cases. It appears in the muscles of the 
throat and renders swallowing difficult; it is also seen in a loss of feel- 
ing in the membranes of the throat; the eye muscles are sometimes 
paralyzed; the muscles of the face are also affected; and the hands and 
feet are in some cases paralyzed. Slow pulse (brachycardia) and fast 
pulse (tachycardia) and even cessation of the heart's action are very 
often noticed. 

Prognosis. — A case of diphtheria, mild or severe, is always a matter 
of very great seriousness. About 10 per cent of the cases die; and the 
mortality is greater among children than among adults. A good 
constitution, retaining of strength and vitality, with a moderate fever 
are good indications. High fever, great swelling, affection of broad 
surfaces, the nose and larynx, bleeding from throat and nose, loss of 
strength, and complications are very serious indications. 

Treatment. — Antitoxin in all cases, mild or severe. Not only the 
patient but all who are or have been exposed, are to be treated as soon 
as possible. This is for the physician to perform and direct. Antitoxin 
serum and treatment are fully explained elsewhere. Rest in bed, 
and a liquid diet (page 277), are absolutely necessary. If it is difficult 
for the patient to swallow, rectal feeding is to be resorted to (page 234). 
The atmosphere of the room is to be moistened by vapor and steam. 
(See page 341.) The strictest attention must be paid to disinfection 
and preventive measures throughout the entire course of the disease. 
(Seepage 155.) 

Alcoholic stimulants may be used from the first very liberally. In the 
presence of the poison of the bacillus it seems that the patient can bear 
large quantities of stimulants, much more than in a state of health, with- 
out intoxication. The following is a useful medicine for internal use : — 



DIPHTHERIA. 5 6 9 

Corrosive Chloride of Mercury, 1-48 grain. 

Tincture of Chloride of Iron, 5 to 10 drops. 

Glycerine, 10 drops. 

Water, 1 dram. 

Take one such dose every two hours in water. 
Or:— 

Tincture of Chloride of Iron, 5 to 10 drops. 

Chlorate of Potassium, 3 to 5 grains. 

Glycerine, y 2 dram. 

Syrup of Ginger, 1 to 2 drams. 

Take one such dose in water every one or two hours. 
The bowels should be kept open by : — 

Calomel, 1-6 grain. 

Bicarbonate of Soda, 1 grain. 

Give one such powder every hour until the bowels move. 

For cleanliness, the throat and nose are to be sprayed with peroxide 
of hydrogen and water, equal parts, every four hours in mild cases and 
every two hours in the daytime and every four hours at night in severe 
cases. Dobell's solution may be used with a spray or swab every two 
hours. 

Another useful swab to be used every three hours is : — 

Carbolic Acid, 20 drops. 

Tincture of Chloride of Iron, 4 drams. 

Glycerine, 1 ounce. 

Water, 1 ounce. 

An effective gargle to be used every three hours is : — 

Chlorate of Potash, 4 drams. 

Carbolic Acid, 2 to 4 drops. 

Tincture of Myrrh, 1 ounce. 

Infusion of Cinchona, 2 ounces. 

Loffler's solution is a useful swabbing application. 
A good nasal syringing preparation is : — 

Sulphite of Soda, 3 drams. 

Glycerine, = 0.2 drams. 

Water, .4 ounces. 

Administer by a syringe every two hours. 

In the application of swabs and sprays to the throat and nose, it is not 
intended that the membrane should be removed. It is impossible to 
effectively remove it; the surface is left sore and bleeding and the 
membrane rapidly forms again. Since the introduction of the antitoxin 



0/ 



CARE OF CHILDREN. 



treatment there has been a great change in the use of these preparations. 
All that is intended is to prevent as far as possible the accumulation of 
the bacilli in these parts with the danger of their being inhaled and 
drawn down into the lungs and stomach. 

The complications enumerated above must be watched and met as 
they occur by proper symptomatic treatment. 

During the period of convalescence, there is need of good nourish- 
ment and stimulation, to restore the strength and to change the anaemic 
conditions. Massage and electricity will be needed if paralysis is 
present. 

There is probably no disease that calls for good nursing and careful 
enforcement of the means of preventing the spread of the disease as 
does diphtheria. 



CHICKEN-POX OR VARICELLA. 

An acute, infectious disease usually occurring in children under 
ten years of age. 

Cause. — It is caused by a micro-organism which has not yet been 
wholly isolated. 

Symptoms. — It appears in from ten to fifteen days from the time 
of exposure to the contagion. There are moderate fever; thirst; con- 
stipation; and vomiting. The fever runs from 103 to 104 . In about 
twenty-four hours the eruption appears in the form of red spots which 
soon fill with a clear or slightly turbid liquid (serum). They have no 
red band around them nor are they hard. They appear in waves or 
crops. They are accompanied by intense itching. This leads the 
patient to scratch or pick the pustules. The effect of this is to cause 
them to affect the skin tissues more deeply and to leave a scar or pock- 
mark. They dry up in about a week, the crusts dropping off and not 
generally leaving a pit unless aggravated as above stated. 

Prognosis. — The disease practically always terminates favorably. 

Treatment. — The disease is usually so mild that no treatment is 
necessary. Exposure to cold must be prevented, although it is not 
always necessary to keep the patient in bed. Careful nursing, and 
attention to diet and warmth, are usually all that are required. If the 
fever is high it may be reduced by giving a few drops of sweet spirits 
of niter in a teaspoonful of citrate of potash solution. 



BOOK VII. 

ACCIDENTS AND EMERGENCIES, 
POISONS AND THEIR ANTIDOTES. 

r. j. McDonnell, m.d. 

Rush Medical College. 

CARRYING INJURED PERSONS. 

A door, a settee, or a shutter will make a good litter. Coats, shawls, 
or blankets will serve for pillows. In placing an injured person on the 
litter, do not place the litter beside the patient, but let the foot of the 
litter be at his head. In this position it is easy to gently lift the patient 
up without fear of stumbling. One of the assistants should devote his 
entire attention to the wounded part. Never let a stretcher be carried 
upon the shoulders of the bearers. It may, if necessary, be supported by 
straps. The bearers must not keep step while carrying a patient on a 
litter. When carrying him uphill, his head should go first ; downhill, his 
feet. 

If the patient can walk, let him be supported and assisted by placing 
his arms around the necks of two helpers. Sometimes a patient who 
cannot walk may be placed in a chair and easily carried. A support or 
"chair" made by the interlocked hands of the assistants is also a con- 
venient mode of carrying one who is not obliged to lie down. 

A form of interlocking three hands is good, as it leaves one arm free 
with which to support the patient's back. 

One assistant may pass his arms under those of the sufferer and lock 
his fingers over the patient's chest, while a second takes the sufferer's legs, 
one over each arm. When any form of carrying other than a litter is 
used, the assistants should keep step. 

If it is necessary to carry the patient upstairs to his room, care must 
be taken that the way is cleared as far as possible that those carrying him 
will have plenty of room. 

Remove the clothing before putting him to bed. If an arm is injured, 
draw the sound arm from the coat, vest, or shirt first. If night clothing 
is put on him, put the injured arm in first. Remove the trousers by rip- 
ping the outside seam. 

The patient may be lifted from the stretcher to the bed in one of two 
ways : first, place the stretcher at the foot of the bed, in line with it, and 
lift the patient bodily over the footboard ; second, place the stretcher be- 
side the bed, one helper between the stretcher and bed and three others 



572 ACCIDENTS AND EMERGENCIES. 

on the outer side. Three stoop down and receive the patient upon their 
knees, where they support him, while the fourth removes the stretcher 
and stands out of the way. The patient is then lifted upon the bed. 

BANDAGES AND BANDAGING. 

Any surgical wound-dressing should be absorbent, to admit of the 
ready impregnation with medicinal substances and to absorb discharges. 
The substances in most common use are absorbent cotton, gauze, lint, 
tow, oakum, jute, wood-wool, moss, peat, and pine sawdust. 

Lint, in the form of "patent lint" is well adapted for wet dressings 
and for spread cerates ; domestic lint is prepared from old linen, boiled in 
a weak alkaline solution, freed from this by washing, dried, and scraped 
on one side with a knife; this latter procedure may be dispensed with. 
Paper lint is moderately absorbent, and can be used with fair satisfaction 
for the application of wet dressings over unbroken surfaces. Absorbent 
gauze is ordinary cheese cloth from which all greasy material has been 
removed by boiling in a weak alkaline solution (e. g., washing soda or soft 
soap), thoroughly rinsing out in pure water and drying. It can readily 
be impregnated with any medicinal agent, and freely absorbs discharges. 
Tow, unless rendered aseptic, should be used only outside other dress- 
ings as an absorbent or to pad splints; the same remark is applicable to 
oakum, jute, and the substances now to be considered. Absorbent cotton, 
made by a process similar to that for preparing gauze, is an exceedingly 
useful material, readily rendered antiseptic by impregnating it with 
antiseptics in solution or in fine powder. It can also be used for wet dress- 
ings. Moss, long-fibered, such as abounds in the far South, cleansed 
and baked, is an excellent outside dressing, as is wood-wool, peat, or 
pine sawdust sewed up in bags of proper size. So far as possible, all the 
substances, even when made antiseptic by germicidal drugs, should be 
previously rendered aseptic by steam under pressure. 

Practically speaking, gauze rendered sterile by steam in the modern 
pressure sterilizer, the antiseptic gauze prepared with corrosive sublimate 
or carbolic acid, the sterile or medicated cotton and the sublimated 
wood-wool, prepared in sheets, are the dressings chiefly used in this 
country. 

For various mechanical purposes surgical dressings are used in the 
form of compresses, firm masses of different sizes and shapes, oblong, 
square, cylindrical, graduated, etc., made by folding up lint, muslin, 
or gauze. All of them should be sterilized. Graduated compresses 



BANDAGES. * 573 

may be either pyramidal or wedge-shaped, and are also formed by super- 
imposing one upon another, in proper relation, a series of square or 
oblong compresses of gradually diminishing size. A square of lint or 
muslin cut from the angles toward its center forms a Maltese cross well 
adapted for snugly applying a dressing over a projection, as a stump. 
Pledgets are compresses formed of cotton, tow, oakum, etc.. in which the 
fibers are pulled longitudinally until most are parallel, the ends folded and 
tucked in, and then formed by pressure of the bands into various shapes. 
They are used externally to other dressings to absorb discharges or to 
exert compression. Tents are small cylinders or cones made by rolling 
strips of gauze or lint, or by twisting masses of oakum into the required 
shape; they are occasionally used to keep wounds open to permit serum 
or pus to escape. If wet dressings are employed, especially where 
warmth is desired, some covering impervious to heat and moisture must 
be used, such as "rubber dam" oiled silk, paper passed through melted 
wax or paraffin, or even stout paper thoroughly greased. 

Roller bandages consist of strips of muslin, preferably unbleached, 
or gauze, varying from one inch to four inches in width and from one 
to twelve yards in length, which are rolled up from one end so as to 
form "single-headed" rollers, or are rolled from both ends, constituting 
"double-headed" rollers. Bandages are rolled either by the hand or 
with some kind of bandage roller. To roll by hand, fold one end for 
two or three inches several times upon itself, then, forming this portion 
into a small mass, roll the bandage upon the thigh until a small cylinder 
is formed. Next, seize this between the thumb and forefinger of the 
left hand, the unrolled portion firmly held between the extended right 
forefinger and thumb, keeping up moderate traction so as to tighten the 
cylinder, which is formed by first supinating (turning palm up) the 
left hand, then, loosening the grip, pronating (turning the back up) the 
same hand to gain a fresh hold, so that by supinating again the cylinder 
will be rolled around its long axis from right to left; this rotation is 
kept up by a series of movements of supination and pronation, the 
remaining fingers of the left hand aiding in the revolution of the cylinder, 
while the extended right forefinger and thumb revolve partly around 
the cylinder. A single-headed roller consists of an initial or free end, 
a terminal one — i. e., that in the center of the roll — and a body, the 
portion between the two extremities. In applying a single-headed roller, 
hold it between the thumb and ringers of one hand, pressing it firmly 
into the palm by the fingers, and always place the external surface of the 
free end on the part to be bandaged to prevent its sudden unrolling: 



574 ACCIDENTS AND EMERGENCIES. 

retain it there by pressure of the fingers of the other hand until it can be 
fixed by one or two circular turns. All bandages must lie smooth 
and flat, each edge exercising the same pressure, otherwise excoriation 
of the skin or interference with the circulation may result. The turns 
of a roller applied to a cylindrical part may pass in a circular manner, 
each turn exactly covering the preceding ones. 

If the part be covered by causing the turns to ascend more or less 
rapidly in a spiral manner, each turn overlapping the preceding one 
about one-third, the result is a spiral bandage. In most limbs the attempt 
to cover with a spiral will result in only one edge of the bandage being 
in contact with the part, the other standing freely off. To obviate this, 
adopt the following manceuver : hold the spiral turn, just made, with the 
fingers of the left hand on the upper surface of the limb, then, with the 
roller held in the supinated right hand, four to eight inches being un- 
wound so as to form a dependent loop, pronate the hand, carry the 
bandage loosely beneath the limb until the opposite side is reached, when, 
by gentle, gradual traction, the reversed turn will snugly apply itself 
to the part; this is called a "reversed turn" or "making a reverse" and, 
combined with the spiral turns, a "spiral reversed bandage." The 
secret of success is to make the loop of bandage turn over without the 
slightest traction, this being made only when the opposite side of the limb 
is reached. 

When a projecting point is to be covered — the elbow, for instance — 
a series of "figure eight" turns, applied alternately above and below, 
will best secure this end, each overlapping its neighboring turn by one- 
third of its width. Such regions as the groin, axilla, shoulder, and breast 
can be best covered by what are essentially figure-of-eight turns, each 
succeeding one ascending from below upward, overlapping by one-third, 
forming a figure like "the leaves of an ear of corn," one member of the 
figure of eight encircling the thigh, for instance, the next the pelvis, 
the next the thigh and groin, and so on; this bandage is called the spica. 

Bandages placed on the extremities should be applied more loosely 
as they advance from below upward, especially if the limb be flexed, 
in order not to interfere with the circulation. Until experience teaches 
the surgeon how firmly turns of a bandage can, with safety, be drawn, 
they should be applied loosely rather than tightly. When used to retain 
dressings or splints, a number of moderately firm turns, passing and 
repassing over one another, will secure better fixation than a single 
layer drawn dangerously tight. All firmly-applied dressings of the 
extremities should leave the fingers and toes exposed ; the patients should 



BANDAGES. 575 

be seen within a few hours, when, if the parts do not feel easy, or if a 
duskiness of the exposed portions is seen, or numbness of the fingers or 
toes is complained of, the dressings should be loosened. If a pin secures 
the end of a bandage, it should be introduced point downward. In 
bandaging the arm to the chest, etc., a pad must be interposed to prevent 
chafing. Skin must never be in contact with skin. 

How to Bandage. — There is not a more important art connected 
with domestic surgery than that of bandaging. To do it well requires 
practice and no little judgment. The material employed in bandaging 
is usually stout, unbleached cotton, from two or three to nine or ten 
inches wide, and from six to twelve yards long; the former length and 
breadth will do best for the leg. 

Bandaging the Leg. — If commenced at the ball of the foot, and 
evenly applied so that each fold overlaps the other about one-third, it 
will reach to the knee. Page 578 will best show the mode of applica- 
tion. The bandage having been first tightly rolled up, is taken in the 
right hand of the operator; the end is passed under the foot, and held 
there by the left hand until it is secured by one turn of the bandage over 
it; an upward direction is then taken, so that a couple of folds brings the 
bandage up to the front of the leg, over the instep; the next turn will 
naturally pass above the heel behind ; and then, if proper care be observed, 
it will go on fold above fold, each overlapping the other slightly, all 
up the leg. The bandage is passed from the right to the left hand 
each time it goes around the leg, and great care should be taken to hold 
it firmly and equalize the pressure, as well as to smooth out any wrinkles 
that may occur in the process of binding. A firm and even support 
is thus afforded to the limb, which is not likely to crease, or get displaced 
by the motion which may be afterwards necessary ; it may be made fast 
above the calf by a couple of pins, or a needle and thread. Great care 
should be taken in this, as in all similar operations, to get the bandage 
rolled up tightly and smoothly before commencing; it may thus be 
grasped in the hand and kept well under the command of the operator, 
who should on no account let go his hold of the bandage so as to relax 
the pressure. 

Bandaging the Arm. — The arm does not require so long or broad 
a bandage as the leg, about two inches, by three or four yards, being 
the average size. This limb is rather more difficult to manage, half 
turns being necessary to effect a proper envelopment. How this is 
effected may be seen by Fig. 79. The bandage is folded back upon 
itself, so as to take a different direction, and cover the space which would 



576 ACCIDENTS AND EMERGENCIES. 

be left exposed by the ordinary method of folding; these half turns, 
unless they are done tightly and evenly, will be be apt to slip and derange 
the whole binding. Some operators avoid half turns by letting the 
roller take its course, and then coming back to cover the exposed parts; 
but this method, besides requiring a larger bandage, does not effect 
the required purpose so neatly and efficiently. One mode of fastening 
a bandage is to split it up a short distance so as to leave two ends, which 
can be passed around the limb and tied. It should always be borne 
in mind that the chief art in applying bandages is to give firm and 
uniform support, without undue pressure upon any part; and to effect 
this properly, the strain, in winding, should be upon the whole roll held 
in the hand, and not upon the unrolled portion of it. This strain should 
not be relaxed during the progress of the operation. 

Many-Tailed Bandage. — Page 578 represents the mode of applying 
what is called a many-tailed bandage — useful to apply over a wound or 
wherever it requires frequent changing, or in cases in which it is 
desirable not to exhaust the patient by much movement of the limb. 
This is a strip of cotton somewhat longer than the limb to be enveloped ; 
on it are sewed, at right angles, other strips, about one-half longer than 
the circumference of the limb, each overlapping the other about one- 
third of its breadth, so that when drawn tightly over in regular succes- 
sion each secures the other. The end of the strip passes under the heel, 
and, coming up to the other side, is made fast to the bandage there, and 
so all is kept firm. 

Cross Bandage. — For keeping poultices on the lower part of the 
back, or in the groin, a cross bandage is used, the fashion of which is 
this : make a cotton band, large enough to pass around the loins, and 
tie a buckle in front; to this is attached another piece, which proceeds 
from the center of the back to the anus, where it divides into two, which 
pass under the thighs, up on either side, and are fastened to the band in 
front. The bandage is used to close a vein after bleeding and is made 
thus: lay the tape obliquely across the wound, pass it around the arm 
above the elbow, and bring it back again over the same spot ; then let it 
go around the arm below the elbow, and, returning, let the two ends be 
tied in a secure bow, in the bend of the arm, with the free movement of 
which the bandage should not be tight enough to interfere, although it 
must be sufficiently so to retain its position. This mode of bandaging 
is called the figure of eight, from its resemblance to that figure. Page 578 
will make the explanation clearer. 

For a Sprained Ankle. — Place the end of the bandage upon the 



BANDAGES. 577 

instep, then carry it around and bring it over the same part again, and 
thence around the foot two or three times, finishing off with a turn 
or two around the leg above the ankle. 

For a Sprained Wrist. — Begin by passing the bandage around the 
hand, across and across, like the figure eight; exclude the thumb, and 
finish with a turn or two around the wrist. 

For a Cut Finger. — Pass the bandage (a narrow one) around the 
finger several times, winding from the top, and splitting the end; fasten 
by tying around the thick part above the cut; or, if it be high up, tie 
around the wrist. 

Bandage for the Eyes. — The best bandage for the eyes is an old 
silk handkerchief passed over the forehead and tied at the back of the 
head. For the head itself, it is best to have a cross bandage, or rather 
two bandages — one passing across the forehead and around the back of 
the head, and the other over the top of the head and below the chin. Or, 
better than this, perhaps, a large handkerchief which will extend all over 
the forehead and crown, two ends of it passing to the back, and, after 
crossing, from thence around the neck, and tying the other two beneath 
the chin. For a bandage to support a pad or poultice under the armpit, 
a handkerchief may be used, or a broad piece of cotton, arranged in the 
same way, or the T-bandage for the eye, as shown on page 582. 

For Fracture of the Ribs. — Bandages should be about nine inches 
wide and drawn around the body very tightly. In this case, as in that of 
any other fracture or discoloration, only a properly qualified person should 
attempt their application. (See articles on Dislocations and Fractures.) 

The T Bandage. — We have not as yet spoken of the T bandage, 
which is simply a broad band to pass around the body, or elsewhere, 
having attached to it one of the same width, or narrower, like the upright 
part of the letter after which it is named; or, there may be two steins — 
if they can be so called — in which case it is a double T bandage, as in 

Fig. 75- 

Starch bandages are those in which the roller, before it is put on, is 
saturated in a strong solution of starch. Sometimes a covering of brown 
paper is put over this, and another dry bandage is applied. This makes 
a firm and compact case for the limb. It is useful in cases of fracture, 
especially if the patient has to be removed to a distance. Sometimes, 
when it is not desirable to make the covering so thick and durable, 
the displacement of the bandages is guarded against by brushing a weak 
solution of starch or gum over the folds. 




ACCIDENTS AND EMERGENCIES. 



Fig. 68. Figure-of- 
Ankle Bandage. 




Fig. 69. Many-tailed Bandagi 
for the Leg. 




Fig. 70. Spica Band- 
age of the Foot. 




Fig. 71. Demigauntlet 
Bandage. 



Fig. 72. Applying Adhesive 
Plaster to a Wound. 



Fig. 73. Spiral Band- 
age of the Finger. 




Fig. 74. 
Gauntlet Bandage. 




Fig. 75. T-Bandage. 




Fig. 76. Spica 
Bandage of the Hand. 




Fig. 77. Pillow Used as a Splint for a Fractured Leg. 



BANDAGES. 



579 





Fig. 78. 



Bandage for Dislocated 
Shoulder. 



Fig. 79. Bandage for Upper and 
Lower Arm and Hand. 





Fig. 80. Bandage for Fractured 
Arm or Shoulder Blade. 



Fig. 81. Dressing for 
Fractured Ribs. 



580 ACCIDENTS AND EMERGENCIES. 

Bandaging should be performed, in nearly all cases, from the extremi- 
ties upwards, or inwards to the heart, except where the injury is 
situated above the seat of the vital action. If they give much pain, there 
is reason to suspect inflammatory swelling beneath; and they should be 
loosened, if moistening with cold water does not relieve the pain. Flannel 
for bandages is used where warmth, as well as support, is required. 

HEMORRHAGE. 

Hemorrhage is invariably present when a vessel is wounded. The 
blood may escape through the broken skin, or may extravasate beneath 
the skin and form a discoloration. The occurrence of severe hemorrhage 
is always attended with great danger to life, and the larger the caliber 
of the wounded vessel, the greater the immediate danger. There is no 
other emergency which the surgeon is called upon to meet that requires 
so much judgment and presence of mind as the proper management of 
an alarming hemorrhage. 

There are four varieties of hemorrhage, as follows : — 

Arterial Hemorrhage is characterized by bright-red blood spurting 
out in jets, keeping time with the action of the heart. The bright -red 
color is due to the presence of oxygen in the blood. Arterial blood may 
be deprived of its characteristic color when the oxygen is greatly 
diminished and carbonic acid gas is present in excess, as in profound 
narcosis, or when an operation is undertaken to avert death from apncea. 
During an operation, therefore, the surgeon always looks to the anesthetic 
if the blood from the wound becomes dark colored. 

Venous Hemorrhage is characterized by the blood flowing in an 
uninterrupted stream and by its dark color. The steady flow of the blood 
from the veins is due to the fact that the intermittent heart impulse is 
lost. For the same reason blood from the distal end of a wounded 
artery also flows in a steady stream. The dark color is caused by the 
non-oxygenation of the blood and by the presence of carbonic acid gas. 

Capillary Hemorrhage is characterized by its constant oozing on 
the one hand, and by its spontaneous arrest on the other. This variety 
of hemorrhage is alarming in exceptional cases only, but its persistence 
often makes it a troublesome variety to treat. The capillaries in the 
mucous membranes bleed most profusely. Hemorrhage from capillaries 
situated in the skin usually ceases, owing to the contraction of the wound. 

Hemorrhage may be divided also into primary, intermediary, and 
secondary. 



BANDAGES. 



58i 





Fig. 83. Spica Bandage 

for Shoulder. 

Fig, 82. Desault's Bandage. Fig. 84. Velpeau's Bandage. 







Fig. 85. Spica Bandage 
for the Groin. 



Fig. 86. 



Fig. 87. Eight-tailed 
Bandage for the Abdomen 





Fig. 88. Adhesive Plaster 
Applied to Fractured Ribs. 



Fig. 89. Figure-of-8 Bandage 
Applied to the Elbow. 



5 82 



ACCIDENTS AND EMERGENCIES. 




'ig. 90. Four-tailed Band- 
age for the Head. 




Fig. 91. Barton's Bandage. 




Fig. 92. Four-tailed 
Bandage for the Head. 




Fig. 93. T -Bandage 
for the Eye. 





Fig. 95. Agnew's 
Bandage. 



Fig. 94. Bandage for Fracture of the Jaw. 




Fig. 96. Head 
Bandage. 





Fig. 98. Four-tailed 
Head Bandage. 



Fig. 97. Head Bandage. 



HEMORRHAGE. 583 

Primary hemorrhage occurs immediately after the wound in the 
vessel. Intermediary hemorrhage usually takes place within twenty-four 
hours, and is caused by a ligature's coming away, or by the action of the 
heart in driving out coagulated blood, or by some movement of the 
wounded part. Secondary hemorrhage occurs after twenty-four hours 
and before the uniting of the wound, and most frequently between the 
fifth and tenth days. 

Arteries. — These may be punctured, contused, lacerated, gunshot, or 
incised. Besides the varieties just mentioned, there may also be rupture. 

A punctured wound is caused by the penetration of the artery by a 
sharp or by a thin blunt instrument. If the opening is very small, hem- 
orrhage may not result, but, if the puncture is of any size, bleeding 
occurs. 

A contused or bruised wound of an artery may be insignificant, or it 
may be of sufficient magnitude to cause gangrene by obliteration of the 
vessel, or death by secondary hemorrhage. If a clot forms in a contused 
artery, which supplies some internal organ with blood, the organ, having 
been deprived of its nutriment, will undergo degeneration. The con- 
tusion may be extensive enough to destroy the coats of the vessel, so that 
a fatal secondary hemorrhage follows the separation of the slough. 

A lacerated wound of an artery deserves special attention, because 
the results are likely to become serious. In a lacerated wound of an artery 
file external coat is drawn out so completely as to lose its normal elasticity, 
in the same manner as a piece of rubber tubing will lose its elasticity 
when it is overstretched. Such an injury to an artery of large or small 
size may occur without any bleeding. The vessel is, however, permanently 
injured. 

A gunshot wound of an artery derives its special importance from 
the fact that secondary hemorrhage is likely to occur. The vessel may 
be only contused by a bullet, and no bleeding occur until some days after 
the injury, when serious hemorrhage supervenes as a result of slough- 
ing. A gunshot wound of an artery is often associated with injury to 
the accompanying vein. In case an extremity is blown off by shot or 
shell, the hemorrhage is often slight, on account of the fact that the 
vessels are lacerated, the middle and internal coats contract, curl up, and 
a plug is formed at the open end of the vessel. If, however, a rifle bullet 
enters the body when it is traveling at great speed, it may cut an artery 
like a knife, causing immediate and alarming hemorrhage. In addition 
to the primary or secondary hemorrhage, which may be produced by 
a gunshot wound of an artery, the contusion of the vessel may lead to the 



584 ACCIDENTS AND EMERGENCIES. 

formation of a clot, which may cause closure of the artery and be fol- 
lowed by gangrene. 

An incised wound of an artery is an injury inflicted by some sharp, 
cutting instrument. The hemorrhage is always profuse in such a wound, 
because there is no mechanical obstacle to the outflow of blood through 
the opening, such as is often found at the open mouth of a torn artery, 
and also because the contraction of the two ends of the vessel causes 
the wound in the artery to gape. The direction of the incised wound may 
be transverse, oblique, or longitudinal. The hemorrhage is very profuse 
in a transverse cut of an artery, while it is not so abundant in an oblique 
incision. If the artery is upon the stretch and is wounded longitudinally, 
the bleeding is very slight, but may become very alarming when the 
artery is relaxed. In case of a partially divided artery the rule is to 
divide the vessel completely and tie both ends. 

Rupture of one or all of the coats of an artery is an injury that occurs 
under certain circumstances. This accident is not followed by hemor- 
rhage, but is a condition favorable to the production of secondary hem- 
orrhage by sloughing, or to the development of an aneurism, or soft pul- 
sating tumor. The rupture may be complete, in which case the artery is 
in the condition of a lacerated vessel. If the rupture is partial and a clot 
has formed, then the pulsation below is lost and gangrene may supervene. 

If the wound is a contused one, the treatment consists in securing 
as much physical rest for the artery as possible by absolute quiet and the 
administration of heart depressants. The possibility of the occurrence 
of secondary hemorrhage must not be forgotten, and measures to arrest 
it must be instituted immediately if it appears. The area or extremity, 
which may be deprived of blood as a result of a contusion of an artery, 
must be kept artificially warm in order to encourage the determination of 
blood to the part and to stimulate the circulation. 

If the wound is a lacerated one, the primary hemorrhage is usually 
slight on account of the curling up of the internal coat and the contrac- 
tion of the middle coat, and the coagulation of the blood at the torn end 
of the vessel ; but on account of the danger of secondary hemorrhage 
both ends of the vessel should be diligently sought, by a careful dissec- 
tion if necessary, and securely tied. 

If the wound is a gunshot one, the primary hemorrhage must be 
treated according to the same principles that would guide the person in 
the management of an ordinary wounded artery. If the vessel is one 
of large size, pressure directly upon the artery and in the wound is 
indicated for the instantaneous arrest of the bleeding. An elastic 



HEMORRHAGE. 585 

bandage should now be applied. If the hemorrhage comes from an 
artery situated in the neck, or in any other place where the application 
of an elastic bandage is impracticable, the dressing of such a wound 
should be conducted with the most rigid adherence to the principles of 
aseptic surgery in order to prevent secondary hemorrhage, a danger 
which is peculiarly frequent after gunshot wounds. The occurrence of 
gangrene is also a complication of an exceedingly fatal character in 
gunshot wounds, since blood poisoning rapidly develops. If the main 
artery of the limb is injured, and also its accompanying vein and nerve, 
even without a fracture of the bone, as a rule, amputation is necessary to 
avert gangrene, which would almost surely follow. 

If secondary hemorrhage occurs, it will be during the second or 
third week — that is, at the time when the sloughs separate. The bleeding 
should be arrested, if possible, at the site of the hemorrhage. If the 
hemorrhage is alarming and it comes from several points, and the pus 
formation is extensive, amputation of the limb is indicated. The best way 
to prevent secondary hemorrhage is to keep the wound aseptic and to 
provide sufficient drainage. Good, nutritious diet is required in order 
to maintain a high standard of vitality, which conduces to repair of the 
wound . and averts the dangers of exhaustion, suppuration, and blood 
poisoning. 

In case of a ruptured artery the treatment is practically the same 
as would govern in the management of a contused or lacerated vessel. 

Bleeding from the Nose may be treated by laying the patient upon 
the back and applying hot or cold applications to the back of the neck; 
cotton, saturated with vinegar, applied to the nose, is of benefit in some 
cases. 

Bleeding (Hemorrhage) from the Lungs cannot be treated by the 
laity, except by laying the patient on the back and applying ice^o the 
chest ; call for a doctor. 

Bleeding from the Stomach cannot be told from that of the lungs 
and must be treated the same. Subacetate of lead, given by mouth, is 
the proper treatment. 

Bleeding from the Rectum and Upper Bowels are known apart 
only from color of blood ; if light, it is from the lower bowel or rectum ; 
if dark, from the upper. Injections of hot water, mixed with vinegar 
or lead water, may be given. Lay the patient on the back, with the head 
lowered. Ice in the rectum may be used. 

Bleeding from the Teeth is most common in the young and very 
old. Some diseases causing deterioration of the blood vessels, are apt 



586 ACCIDENTS AND EMERGENCIES. 

to allow profuse bleeding upon the extraction of the teeth. Applications 
of alum, tannic acid, or vinegar will give relief. 

Hemorrhage through the Vagina is caused by many things, and 
will be taken up in other chapters. The emergency is of little value. 
Hot water douches with the addition of one teaspoonful of salt to each 
quart of water may be used. Placing ice over the abdomen is a remedy 
that may prove beneficial. The patient must be put to bed, — elevating the 
lower end of the bed upon a chair will give the desired position. Call a 
physician at once. 

WOUNDS— RAILWAY AND MACHINERY ACCIDENTS. 

Crushed Fingers or Toes. — Wash the parts, straighten them into 
their proper shape as nearly as possible, cover them with oil and bandage 
them with a piece of soft cotton cloth, wrung out of hot water, and then 
attach a splint. 

Crushed Feet or Hands. — Bathe the parts with oil, wrapping in a 
soft dressing, such as cloth, cotton, or wool. If there is much bleeding, 
apply ice or cold water. Support the part by a splint and place on a 
level with the body. Let the patient lie down. If there is shock or 
depression, keep the patient warm, applying hot water bottles or hot 
cloths, and give only a teaspoonful of whisky or brandy in a little hot 
water every ten minutes. 

Crushed Arms or Legs. — In such cases the shock is usually very 
great. The patient is to be supported, kept warm, and stimulants are to 
be given. Do not move the organ. If it is necessary to expose the part, 
cut the clothing away, and, after treatment, see that it is warmly pro- 
tected. 

Crushed Chest or Lower Part of the Body. — As such cases are 
nearly always fatal, little can be done beside provision of warmth, com- 
fortable position, and slight stimulation by a teaspoonful of whisky or 
brandy in hot water every ten minutes. 

Parts Torn Off. — Parts should be cleansed, treated with cold water 
or ice, and the patient placed in such a position that the injured part is 
higher than any other. When shock occurs, apply heat, if possible, to 
the whole body and especially to the region over the heart and the pit 
of the stomach. Give stimulants with a teaspoonful of brandy or whisky 
in a tablespoonf ul of hot water every ten minutes for several hours. 

Bruises or Contusions. — Apply cool, wet cloths or ice bag and 
anoint the part with vaseline, cold cream, or similar simple ointment. 



WOUNDS. 587 

The pain may also be relieved by applications of laudanum, full strength, 
or mixed in equal parts with water. After the pain has subsided, apply 
hot cloths, which will help to prevent discoloration of the skin. 

Contused Wounds. — If there is much bleeding, warm applications 
are better than cold ones. If dirt of any sort is present in the wound, 
cleanse it thoroughly and apply a simple ointment, such as vaseline or 
cold cream, to assist in its removal. Tincture of arnica, mixed with hot 
water, will also afford relief. Tincture of benzoin or Friars' Balsam 
may be applied on lint or absorbent cotton; it has the effect of sealing 
up the wound, preventing the contact of air and enabling it to heal. Its 
application will cause a slight smarting if the skin is broken. 

Cuts or Incised Wounds. — When these are simple and small, the 
edges of the flesh are to be drawn together with narrow strips of adhesive 
plaster after the parts have been well cleansed. For the latter purpose 
a few drops of carbolic acid in a quart of water makes an excellent wash. 
The more care taken in bringing the edges nearly together, the less danger 
there is of an unsightly scar remaining. A wash with a little collodion 
applied with a camel's-hair brush makes an effective dressing. A bandage 
is then applied for additional protection. In larger and longer cuts, some 
stitches are necessary. While this is a matter wholly relegated to the sur- 
geon, in cases where he cannot be reached it is only a matter of nerve and 
a little ingenuity. A needle and black silk or cotton thread, both boiled 
for five minutes before using to prevent infection, are all that are 
required. The stitches are to be taken well back from the edges of the 
wound so as to insure that they will hold. A dusting of iodoform will 
assist the healing process. 

Torn or Lacerated Wounds. — The torn parts are to be thoroughly 
washed so that all dirt and other foreign matter is completely removed. 
Then apply a cool, wet cloth, or one soaked in laudanum or equal parts 
of laudanum and water, or with alcohol. When there is shock or 
depression, warmth, rest, and stimulation from small, frequent doses 
of whisky or brandy in hot water are required. 

Punctured Wounds. — First ascertain whether or not any part of the 
needle, pin, tack, nail, or other object has broken off in the wound. Soak 
the part in hot water and squeeze out a little blood if bleeding has not 
occurred. This is to remove any poisonous matter, which is the great 
fear in such cases. If puncture of the abdomen, chest, or head occur?. 
a physician must be called at once, as the vital organs may be injured. 
If a rusty nail or wire is the cause of the wound, there is need of having 
it cauterized (or burned). 



S 88 



BANDAGES. 




Fig. 99. For Stopping a Hemorrhage. 




Fig. 100. Extension of a Limb in Fracture. 





Fig. 101. Tourniquets for Stofping Excessive Bleeding. 



FRACTURES. 589 

HEALING OF WOUNDS. 

Under the condition of asepsis we are now able t© see wounds heal 
without the usual phenomena of inflammation. The symptoms of inflam- 
mation are brought about by the disturbed functions of tissues which have 
been damaged. Repair, on the other hand, is the result of an active 
process by means of which the cells of the part are enabled to replace 
the tissues which have been destroyed. 

In healing by first intention, or primary union, repair takes place 
without suppuration. The bleeding of the smaller vessels soon ceases 
spontaneously because they are soon obstructed by the formation of 
a clot. The largest vessels are controlled by pressure, twisting, or 
ligature. When the blood has been washed or wiped away, the edges 
of the wound are carefully adjusted. If such a wound has been kept per- 
fectly aseptic — that is, if no bacteria have been allowed to gain access 
to it — we shall see but little change in the appearance of its edges during 
the healing process. 

FRACTURES. 

Definition. — By fracture in the surgical sense we mean the breaking 
of a bone or cartilage. The several sorts of fracture are : — 

Compound or Open Fracture. — That in which the seat of fracture 
communicates with the exterior through a wound of the overlying parts. 

Simple or Closed Fracture. — That which does not communicate with 
the exterior. 

Other general terms used are : spontaneous fracture — one produced 
by very slight violence, presumably aided by abnormal weakness of 
the bone ; ununited fracture — one by which bony union has not yet taken 
place, after the lapse of a period of time that is usually sufficient for 
repair; fracture by direct violence — one in which the bone is broken by 
external violence applied at the seat of the fracture ; fracture by indirect 
violence — one in which the force is applied to the bone at a distance from 
the seat of fracture. A comminuted fracture is one in which the bone 
is much shattered. Green-stick fracture is an incomplete fracture in 
which the fibers of the bone are unbroken but twisted. 

Symptoms. — Pain ; tenderness ; loss of use of the part ; fever ; 
deformity; inflammatory swelling; unnatural freedom of movement; 
and crepitus. This last named symptom is a grating sound and sensation 
given when the broken ends of the bones are slightly moved over one 
another. It is the most reliable symptom. 



590 ACCIDENTS AXD EMERGENCIES. 

General Treatment. — Setting the fracture by pulling the parts so as 

to bring the broken ends together; retention of the parts in their proper 
position by splints, bandages, and other means. 

Fracture of the Leg. — Treat the patient, if possible, on the spot 

where the accident has occurred. Do not touch or handle the limb 
until all splints and bandages are ready. Handle the limb with the 
utmost care and gentleness, so as to avoid all unnecessary suffering. 
When splints and bandages are ready, grasp the limb above and below 
the fracture and pull with a gentle, steady force, so as to bring the two 
extremities of the broken bone as nearly as possible together, then apply 
the splints and bandages so as to make the patient comfortable and to 
render his removal easy. Under no circumstances must the patient be 
allowed to place his weight upon the injured member. The jagged ends 
of the bone will lacerate the muscles if any motion of the limb is per- 
mitted. In some cases the fractures may be reduced by pulling the foot 
in a straight line with the body. Swelling occurs almost at once; unless 
this is kept down the surgeon will have much difficulty both in diagnosing 
the case and in reducing the fracture. Hot cloths or applications of ice 
are the best means of keeping down the swelling. If the fracture is 
compound, that is, if the ends of the bone protrude through the flesh, 
there is danger of infection or of blood poisoning. The wound should 
be cleansed with pure soap and water. A few drops of carbolic acid 
added to a quart of water makes an ideal wash. After this, the part 
should be dried with a clean towel and bandaged with a clean cloth. 
(See ''Splints and Bandages," page 572, and "Modes of Transporta- 
tion," page 5/1.) When the leg is broken below the knee, the fracture 
should be reduced by pulling upon the foot ; a pillow is then placed under 
it and the leg and pillow are firmly bound together by three bandages 
distributed equally along its length and tied above and over the shin. If 
splints are used, apply one on each side of the leg. and bind these with 
strong bandages arranged so that the knots come over one of the splints 
and not over the leg. 

Fracture of the Arm. — This fracture may be reduced by either 
grasping the arm above and below the fracture or by pulling on the 
hand with slight force in a straight line and continuing to exert this force 
until splints and bandages are applied. If it is necessary to transport 
the patient any considerable distance, carrying the arm close to the side 
with a weight in the hand, such as a heavy flatiron, will insure relief 
from pain. Wnere the small bones of the hand are fractured, almost 



FRACTURES. 591 

the only treatment possible in an emergency is the application of either 
hot cloths or of ice to keep down the inflammation and swelling. 

Fracture of the Skull. — Remove the patient to a cool, dry place, 
placing him in a recumbent position. Apply ice to the head and avoid 
anything which will tend to excite the patient. Place clean cotton or 
cloth over the head and make no attempt to stop the flow of blood, un- 
less an artery is severed. In removing the patient, place on a stretcher, 
shutter, or wide board with the head raised higher than the rest of the 
body, and observe great care in carrying him. The room in which he 
is placed should be darkened and kept absolutely quiet. Hot water 
bottles may be placed at the feet and an ice bag at the head. Give 
alcoholic stimulants. 

Fracture of the Jaw. — The broken ends of the bone are to be gently 
forced into their natural position, and are to be so retained by a band- 
age. In case of bleeding, let the patient rinse his mouth out frequently 
with cold water or small pieces of ice. He must not be permitted to 
talk. 

Fracture of the Spine. — This is to be suspected when there is paraly- 
sis of the parts below the seat of the injury. Do not move the patient 
until medical assistance arrives if it can be avoided. As this injury is 
nearly always accompanied by shock, give alcoholic stimulants in small 
quantities and apply hot water bottles to the feet. If the patient must 
be removed, a shutter or board is preferable to a canvas stretcher, as 
the former w T ill not permit of so much motion as does the latter. Place 
the patient on his back, carrying him as gently as possible, and avoid 
jolting. 

Fracture of the Ribs. — If there is no evidence of injury to the lungs, 
a bandage is to be tightly tied around the chest over the seat of the 
injury. If there is evidence of internal injury, do not bandage at all. 
Place the patient in bed with head and upper part of the body elevated. 
In carrying the patient this position is also to be observed. As the 
pain is greatly increased by the act of breathing, strips of adhesive 
plaster may be placed around the chest over the seat of the injury. 
These strips should be about two inches wide and extend from the 
spinal column a little beyond the breastbone. Begin to apply them 
from below and work upwards allowing the strips to overlap about an 
inch. 

Fracture of the Collar Bone. — Make a pad of cotton in the form of 
a wedge about three inches wide at the base and running up to a point; 



592 ACCIDENTS AND EMERGENCIES. 

place this in armpit with the broad end upwards. Place the arm 
close to the side and push the elbow up as high as possible, carrying 
the forearm across the chest with the head pointing to the opposite 
shoulder, the elbow carried as far back as possible. Retain this position 
by means of a broad bandage. Arrange the bandage in such a way as 
to take the weight of the arm off the shoulder. 

Fracture of the Fingers.— Reduce the fracture by pulling directly 
in a straight line below the seat of the injury. Arrange a splint ex- 
tending from the elbow to the tips of the fingers and attach hand and 
arm to it by means of a bandage so arranged that the pressure comes 
directly over the fingers. Bind the arm and elbow and arrange a sling 
bandage in which the injured member may be carried. 

Fracture of the Kneecap. — Take a long splint reaching the entire 
length of the leg. Straighten the limb and apply the splint to the back 
of the leg. Tie this to the limb by means of one bandage around the 
thigh and another around the lower leg, then tie the two feet together 
around the ankles. The patient may be carried on a stretcher, and 
placed in a bed with a very low pillow. 

SPRAINS. 

Sprained Wrist. — Make a splint the width of the hand and tapering 
to the width of the wrist. Let it be long enough to extend from the 
tips of the fingers to the elbow. Pad the upper surface of this with 
cotton or wool or old table linen to make a soft rest for the hand and 
arm. Lay the hand upon it palm down and pass a broad strip of ad- 
hesive plaster around both splint and arm above the wrist, and a similar 
one just below the wrist. A bandage may then be applied over all. 
This secures rest, the first essential. 

To reduce swelling, bathe the wrist with cold water or with hot 
water, as may be most agreeable to the patient, or, wrap cloths kept 
wet around the joint. 

Massage, very gentle at first and gradually increasing in force, is 
extremely beneficial. 

Sprained Ankle. — Movement of the joint is best prevented by strips 
of adhesive plaster passed up and down and partly around the ankle, 
but not so as to bind tightly when the swelling occurs, nor to interfere 
with the circulation. 

Swelling is reduced by either hot or cold applications. The foot is 
to be placed in an elevated position. Massage should be begun early, 
usually on the first day. If the rubbing is gentle at first it will be well 



DISLOCATIONS. 593 

borne, and the force employed may be increased at each succeeding 
treatment. 

Prognosis. — Sprains range through all degrees of severity. Some 
are so severe and are so slow in getting well that it has been said that 
a sprain is worse than a break. As the joints of the wrist and the 
ankle are so complicated, it is an extremely difficult matter to tell 
whether the injury is not accompanied by a fracture or crack of some 
of the bones. The swelling adds to the difficulty of correct diagnosis. 
X-ray examination has shown that many supposed sprains were in 
reality fractures. 

The discoloration of the skin is due to the flow of blood into the 
cavity of the joint and through the tissues. Blood clots form and adhesion 
of the parts often interferes with the usefulness of the joint. 

DISLOCATION OF THE ELBOW. 

Treatment. — Take the patient by the hand and forearm and pull 
with increasing force until the joint slips into place with a snap. Not 
much is required in ordinary cases. AVhen the joint has slipped into 
place, the arm should be bandaged on a splint covering the elbow joint. 
It should be kept in its place in this way for five or six weeks. 

Symptoms. — The joint is motionless; a little bent; a projection 
behind, formed by the elbow, which, with its tendon, is pushed back. 
The joint can be neither bent nor straightened. Great care is needed 
to distinguish between a dislocation of the elbow joint and a fracture at 
this point. When both bones of the elbow are forced forward, the elbow 
is broken. The imperfect line of the joint will be readily observed when 
a comparison is made with the opposite joint. 

DISLOCATION OF THE LOWER JAW. 

Treatment. — Place the patient in a low chair or seat. Pass the 
thumbs, well protected with several thicknesses of cloth, into the mouth. 
Press with force, slowly applied, on the last four teeth, and at the same 
time raise the chin, pushing the jaw backward. As soon as the jaws 
start to slip into place, the operator is advised to slip the thumbs off the 
teeth into the cheeks to avoid the pinching which is caused by the sudden 
reaction of the muscles, which have been unduly stretched. The pressure 
required by the thumb is considerable. 

Symptoms. — The mouth is fixed open ; pain in front of the ear ; pain 
extending upward into the temples. 



594 ACCIDENTS AND EMERGENCIES. 

Causes. — This state of the jaw occurs suddenly, while gaping, eating, 
talking, while the jaw is in motion. It is very likely to recur. 



DISLOCATION OF THE SHOULDER. 

Lay the patient down at full length, on the floor if nothing better of- 
fers ; place yourself alongside of him in the reverse position — that is, with 
your feet toward his head. Remove your boot or shoe from the foot that 
is nearest to him. Place your foot in his armpit ; take the hand of the dis- 
located arm ; press the foot up in the armpit for a leverage ; pull upon the 
hand. At the same time carry the hand rather across the body towards 
the well side. This, with the leverage of the foot in the armpit, has the 
effect of prying the end of the long bone upward and outward so that, 
if sufficient force is exerted, the head of the long bone of the arm will 
snap into place. Sometimes the ligaments and muscles bind so tightly 
that the dislocation will not yield to your strength. In such cases it is 
better to wait for the doctor, who will probably administer an anesthetic, 
which has the effect of relaxing the strain of the parts. 

After the dislocation has been reduced, bind the arm to the side with 
the hand resting on the opposite shoulder. 

Dislocation of the shoulder is the most frequent of all dislocations. It 
composes nearly one-half of all dislocations. 

DISLOCATION OF THE FINGERS. 

Treatment. — These are usually easily reduced by strong pulling 
and a little pressure on the ends of the bones forming the joint. The 
parts are then to be kept in position by means of a splint and a bandage, 
or strips of adhesive plaster. 

DISLOCATION OF THE THUMB. 

Treatment. — This is often a matter of great difficulty to even an 
experienced surgeon. If pulling in a straight line will not reduce the 
dislocation, the thumb is bent backwards towards the wrist and pressure 
made at the same time on the end of the thumb bone at the point of 
dislocation so as to push it away from the wrist. The pressure at the 
same time is exerted downwards towards the palm of the hand. A splint 
or strips of adhesive plaster are required to keep the part in place.. 



CONVULSIONS. 595 

DOMESTIC EMERGENCIES. 

Infantile Spasms. — Convulsions similar to those seen in cases of 
epilepsy often occur in infancy and occasionally among adults. They 
may be identical with epilepsy, but in early childhood are not necessarily 
followed by that disease. They differ from the former in that the spasms 
of infants subside when their cause is removed, while epileptic spasms 
continue. 

Causes. — Convulsions may be due to a variety of causes, producing 
an unsettled nervous condition, which finds expression in that way. One 
of the most common is debility resulting from disturbances of the digestive 
tract. It has been shown that the death rate in spasms is proportionate 
to that of stomach and intestinal troubles. Although dentition itself 
is not often a cause of convulsions, in a sickly, weak infant, it may assist 
in producing them. Overloading the stomach is one of the most common 
causes. The popular idea that worms often produce spasms is doubtless 
erroneous. Many times the onset of scarlet fever, pneumonia, or measles 
brings an attack, while in an adult a chill may be the first warning. Con- 
vulsions often occur with meningitis and with various brain troubles. 

Symptoms. — An attack is usually preceded by a state of restlessness 
and perhaps grinding of the teeth. It often begins in the hands. The 
eyes roll up or become fixed and staring. Breathing may be suspended 
for a short time, causing the face to become gray or purplish, and giving 
it a pinched, drawn look. Then the hands and arms may twitch con- 
vulsively or be moved forward and backward, rhythmically, the eyes roll, 
and the head is drawn back. Gradually the convulsion subsides and the 
child sinks into a stupor or falls asleep. 

Treatment. — If there is reason to think the attack is brought on by 
indigestible or too much food, an emetic should be given at once and then 
an enema. The teeth should be examined and, if a gum is swollen and 
undoubtedly causing trouble, it may be lanced. The almost universal 
practice of putting the child into a warm bath is excellent and should 
be done immediately; but a very hot bath is not to be recommended, 
especially if indigestion is the cause of the spasm. The temperature of 
the water should not be above 95 ° F. After the convulsion is over, and 
especially if there is fever, cold water or an ice bag may be put to the head. 

Colic commences with a feeling of pressure, then severe griping pains 
in the stomach, faintness, and cold extremities. For the paroxysm, 
hypodermic injections may be given by a physician; galvanic electricity, 
if a battery is handy; a hot water bag over the stomach is excellent 



596 ACCIDENTS AND EMERGENCIES. 

Diarrhoea. — If the tongue is coated, the breath bad, and the stools 
not excessive in number, clean out the bowels by a mild laxative. Eating 
should be suspended for a time ; an occasional glass of milk may be taken 
and mild stimulants ; rest in bed, hot baths, sweating, and induced activity 
of the kidneys are to be recommended. 

Dysentery. — Put the patient to bed at once; remove and disinfect 
all stools, as the disease is infectious ; the diet should be mild but nourish- 
ing; if there is great prostration, mild stimulants may be given. 

Croup. — Emetics of warm or mustard water should be given to 
remove the membrane; however, at the first appearance of symptoms of 
croup, a physician should be called. 

Whooping Cough. — This disease will "run its course." Inhalations 
of creosote emanating from saturated cloths hung in the room or vapor- 
ized are very good. Eucalyptol is excellent to inhale. The diet should 
be mild and nourishing, the clothing warm, but not burdensome, and the 
patient kept outdoors as much as possible. 

Toothache. — Insert cotton saturated with oil of cloves or carbolic 
acid into the cavity; place hot applications to jaw. 

Earache. — Drop warm sweet oil or chloroform into ear; use hot 
applications. 

Neuralgia. — Rest; easily digested food; for prompt relief, hypoder- 
mic injections ; hot applications. A physician should be consulted and the 
cause removed if possible. 

Vomiting. — Keep perfectly quiet, eat nothing; chopped ice may be 
held in the mouth ; drink lemon water or "suck" the fruit. 

Cholera Morbus. — Hot applications over the abdomen, brisk 
cathartic ; hot drinks, preferably ginger ; otherwise treat as for shock. 

Pneumonia. — Put patient in bed ; keep quiet ; clear out bowels ; give 
only milk diet; turpentine and lard may be applied to the chest; if the 
fever is high, cool sponges are beneficial. Summon a physician without 
delay. 

Fever. — Keep quiet ; ice may be held in the mouth ; sponge with cool 
water if temperature is high ; milk diet is best. 

Asthma. — If an attack impends, drink freely of strong, black coffee ; 
for the paroxysm, hypodermic injections afford relief; inhalation of the 
fumes of belladonna or chloroform, and the use of some kinds of ciga- 
rettes, will help. If attacks are frequent, systematic exercise, frequent 
bathing, restricted diet, and change of climate are to be recommended. 



BURNS AND SCALDS. 597 

BURNS AND SCALDS. 

Remove the clothing carefully so as not to break blisters or to tear 
away the skin. If the clothing sticks to the burned part, do not use 
force to remove it. Cut around the attached part, if necessary, and soak 
off the clothing which adheres. 

If blisters have formed, open them with a needle at the edge, and 
allow the watery contents to run out so that the upper layer of skin will 
settle down on the under layer. 

Apply dressings of soft linen cloth or pieces of old muslin or cotton 
cloth soaked in any of the following : — 
Castor Oil. 

Or:— 

Good Olive Oil. 

Or:— 

Baking Soda, 1 heaping tablespoonful. 

Water, 1 pint. 

This is one of the best remedies that can be employed. 
Or 

Vaseline applied to a soft cloth. 



Or 
Or 



Raw White of an Egg applied on a cloth. 



Linseed Oil, 1 cupful. 

Limewater, 1 pint. 

This is known as Carron Oil and is excellent; used in hospitals. 
Or:— 

Carbolic Acid, 1 teaspoonful. 

Glycerine, 2 tablespoonfuls. 

Olive Oil, 1 pint. 

If the patient faints from shock, place the ammonia bottle or smelling 
salts to the nose and give only moderate quantities of a stimulant such as 
brandy and water or aromatic spirits of ammonia. 

If the pain is intense and the burn very severe, the pain is allayed by 
giving laudanum. An adult takes thirty drops; a child takes as many 
drops as he is years old. 

CLOTHES CATCHING FIRE. 

Wrap the person in a woolen covering such as : a rug, a blanket, a 
carpet, a shawl or a coat. Wrap it around closely so as to shut out the 
air from the flames and smother them. Do not let the person run about 
in fright. That only fans the flames and makes them burn the faster. 



598 ACCIDENTS AND EMERGENCIES. 

Whatever is used to smother the flames is to be wrapped snugly around 
the neck so as to keep the flames from the face. 

Then treat the burn as directed above. 

Do not use a cotton material in an attempt to smother the flames. 
Cotton burns too easily and only feeds the flames. 

BURNS WITH ACIDS. 

Bathe the parts liberally wth water so as to wash away all acid from 
the part. 

Then treat as directed above for ordinary burns. 

BURNS WITH LYE AND ALKALIES. 

Wash the part with vinegar and apply oil. 

Nature of Burns and Scalds. — Scalds are likely to be more exten- 
sive, because the clothing carries the fluid over the body. In burns it 
is more likely to protect the body. 

There are three degrees of burns and scalds, viz. : ( i ) Those present- 
ing only a reddened surface. (2) Those in which the skin is blistered. 
(3) Those in which the flesh is involved. 

Prognosis. — The prognosis depends upon the extent and the depth 
of the injury. 

Reddening of two-thirds of the skin will probably produce death. 

Destruction of the skin on one-third of the body will produce death. 

Where the flesh is involved, the result depends upon the location and 
depth of the injury and the age, sex, and previous health of the patient. 

When death results very soon after the accident, it is caused by shock 
and the reaction from congestion of the internal organs. Death at a 
later period comes from exhaustion, blood poisoning, or lockjaw. 

The pain varies from moderate to intense agony. 

BITES AND STINGS OF INSECTS. 

Minor and Common Insects. — Fleas, mosquitoes, bedbugs, various 
forms of mites, etc. ; bees, wasps, hornets, yellow jackets, etc. ; spiders, 
centipedes, tarantulas, and scorpions. 

Treatment. — Make a paste of baking powder and water and apply to 
the part. 

Bathe the part in dilute ammonia (hartshorn). 

If these are not at hand, make a poultice of ordinary loam or earth, 
and apply it to the part. 



SNAKE BITES. 599 

If the sting is visible, remove it with forceps or pliers before treatment. 

Apply wet salt to the part. 

Bind a slice of onion over the wounded point. 

The poison by which a bite or sting from an insect inoculates is acid 
in chemical properties, therefore any alkali, such as ammonia or soda, at 
once neutralizes the poison. 

Prognosis. — As a rule, the stings and bites of even the most venom- 
ous of the insects are not dangerous to life. Where a great number of 
insects attack a person at once, as a swarm of bees or a nest of hornets, 
it is possible for one to be stung to death. A person who is very weak 
may suffer great constitutional disturbance marked by chills, fever, 
great prostration, and even death. The wounds inflicted by spiders and 
scorpions of the largest size rarely prove fatal. 

SNAKE BITES. 

Treatment. — If the snake is considered venomous, and the wound is 
in the extremities, tie a broad band or strap around the limb above the bite, 
and draw it tight enough to stop the circulation of the blood in the limb. 

Suck the poison vigorously out of the wound. Take care that 
there are no wounds or sores or other breaking of the skin in the mouth 
for the poison to enter. If there are none, the poison may be safely taken 
into the mouth. 

Or:— 

Burn the wound with a hot iron so as to close up the ends of all of the 
absorbent vessels. 

Or:— 

Cut out the wound so as to remove all of the poison. 

The free use of alcoholic stimulants should be resorted to. Only a 
moderate degree of intoxication is to be permitted. The alcohol does not 
act as an antidote to the poison, but only sustains the system and elimi- 
nates fear, which is a potent factor in the condition of the person. 

The strap or ligature around the limb is to be loosened after the 
wound has been sucked, cut out, or burned; but the slackening is to be 
only for a moment at a time. Then tighten it again. Slacken and tighten 
at intervals of a few minutes to permit such poison as there may be left in 
and near the wound to enter the circulation only a little at a time, while 
the general means of overcoming the effects are being employed. 

For an unskilled person, the hot iron is the best to use. Don't be 
afraid to use it vigorously on the wound. Remember you are trying to 
save the person's life. 

If no one present has the nerve to cauterize the wound or to cut it 



600 ACCIDENTS AND EMERGENCIES. 

out, put gunpowder on the wound and set fire to it. Repeat until the 
wound is well cauterized. 

Touch the wound with strong nitric acid. 

Apply a strong solution of potassium permanganate. 

Wash the wound thoroughly and then apply a twenty-five per cent 
solution of carbolic acid, made by mixing one teaspoonful of carbolic 
acid with three teaspoonfuls of water. 

Counteract the shock by rubbing the patient vigorously; give strong 
coffee ; apply the ammonia bottle to his nose ; give whisky in from 2 to 8 
teaspoonful doses or more every ten or fifteen minutes. Also give aro- 
matic spirits of ammonia in teaspoonful doses in a little water every ten 
or fifteen minutes. 

If breathing is difficult, use artificial respiration and keep it up for 
several hours if necessary. 

The patient should be kept warm, perspiration should be free, and he 
should be as quiet as the treatment will permit. Give him plenty of fresh 
air. 

Symptoms of Snake Poisoning. — After the poison has entered the 
circulation there are : severe pain in the part bitten ; shock ; intense thirst ; 
skin clammy ; swelling of the part ; black -and blue discoloration ; nausea 
and vomiting ; labored breathing ; hemorrhages ; bloody stools and urine ; 
convulsions; and death. 

Prognosis of Snake Bite. — There are, in the United States, twenty- 
seven species of poisonous snakes, and one poisonous lizard. Eighteen 
of the poisonous snakes are true rattlesnakes ; the remaining varieties are 
moccasins, or copperheads, or vipers. The poisonous lizard is the Texan 
reptile known as the ''Monster of Gila." 

It is said that the poisonous snake is thicker than the harmless ones, 
and is rougher on the surface, because the scales on the back have enlarge- 
ments known as keels. 

CHOKING. 

This accident, caused by substances getting into the gullet, or stopped 
between the mouth and the stomach, is extremely dangerous, and gen- 
erally the effect of carelessness. 

Treatment. — Slap the back smartly but not too heavily, and in the 
meantime let the person swallow some crumbs of bread, and drink a 
draught of water. Or, press a finger immediately down the throat as 
far as possible. Or, take large draughts of water, and make great efforts 
•to swallow. The quantity of water distends the gullet above the lodged 



SUNSTROKE. 601 

food, alters its position, and both water and food pass into the stomach 
with a sudden jerk. A strong emetic will sometimes effect the purpose 
when other means fail ; mustard mixed with warm water is as efficacious 
as any. 

HYDROPHOBIA. 

Immediately fasten a strap or broad band around the limb above the 
wound and draw tight. Apply tincture of iodine in and around the 
wound. 

Wash the wound with hot water and suck out the poison. 

Apply a twenty-five per cent solution of carbolic acid, made by mixing 
one teaspoonful of carbolic acid with three teaspoonfuls of water. 

Cauterize the wound with hot iron, but not with nitrate of silver. 

Cut out the bitten part. 

Apply ammonia water to the wound. 

(See " Hydrophobia," page 402.) 

Do not kill the dog ; keep him to see whether or not he is affected. If 
he has an appetite after four days, or, in case of death, if he does not 
die from paralysis, he is not mad and there is no fear. 

Hydrophobia may result from the bite of a dog, cat, wolf, fox, or 
other flesh-eating animal. 

SCRATCHES OR BITES OF CAT— BITE OF RAT. 

Cleanse the wounds thoroughly by washing. 

Squeeze the wound while held under hot water. 

Wash with ten per cent solution of carbolic acid, made by mixing : — 

Carbolic Acid, 1 teaspoonful. 

Water, 9 teaspoonfuls. 

Afterwards apply a simple ointment. 

Prognosis. — The teeth and claws of cats and rats are often contami- 
nated by poisonous matter, and this infects the wound. Unless the pre- 
cautions mentioned are taken, blood poisoning may result.' 

SUNSTROKE. 

Synonym. — Heat stroke, thermic fever, heat exhaustion. 

Definition. — A depression of the vital powers resulting from exposure 
to excessive heat. The condition manifests itself as acute heat exhaus- 
tion and as true sunstroke. 

Causes. — Exposure to the influence of excessive heat, either to the 
direct rays of the sun or artificial heat in confined quarters, or diffused 
atmospheric heat without proper ventilation. 



602 ACCIDENTS AND EMERGENCIES. 

Among the predisposing causes which act by lessening the power 
of the system to reduce the heat, are great bodily fatigue, overcrowc.ing, 
and intemperance. 

Symptoms. — Heat exhaustion develops with a rapid feeling of 
weakness and prostration, the surface cool, the face pale, the voice weak, 
the pulse rapid and feeble, the vision growing dim and indistinct, noises 
develop in the ears, the individual, overcome, becoming partially or com- 
pletely unconscious. In such cases the attack of prostration is sudden 
the patient falling unconscious, with, perhaps, convulsions. 

Sunstroke. — The symptoms, developing suddenly, are insensibility, 
with or without convulsions or paralysis; the surface flushed and hot; 
breathing either rapid or shallow ; or labored and slow. 

Diagnosis. — It is of great importance to distinguish at once between 
attacks of sunstroke and heat exhaustion. Cases of sunstroke are to be 
differentiated from alcoholic insensibility, for which purpose the clinical 
thermometer is indispensable. 

Attacks of heat exhaustion, if properly treated, make favorable re- 
covery. The prognosis of sunstroke is unfavorable in the majority of 
cases. Unfavorable indications are increased temperature, convulsions, 
followed by complete muscular relaxation. Favorable indications are 
decline in surface heat and return of consciousness. 

Treatment. — Cases of heat exhaustion should be treated by placing 
the patient in a recumbent position with the head low and by the use of 
stimulants. For sunstroke, the indications for treatment are the very 
opposite. The patient is in imminent danger from the extraordinary 
temperature, and measures to reduce it must at once be instituted. Of 
these none gives such excellent results as the rubbing with ice or the 
cold bath or cold pack. The wrapping of the patient in a wet sheet, if 
consciousness has not been regained, should be tried. 

LIGHTNING STROKE. 

Instantaneous death or only temporary unconsciousness may result. 
Sometimes superficial or deep burns or paralysis of special nerves or 
those of sensation and motion may be occasioned. 

Treatment. — The application of external warmth, artificial respira- 
tion, and stimulants are indicated. The wounds must be treated as 
ordinary burns. 

FROSTBITE. 

This term is used to designate the local results of cold. The depress- 
ing effect of cold upon the local circulation of the part is such that this 



VERTIGO. 603 

ceases and the part may be actually frozen. With due care the vitality 
may yet be restored, but even when actual freezing of the part has not 
occurred, unskillful treatment will result in gangrene. 

Symptoms. — At first numbness and tingling, then loss of power, 
usually commencing in the fingers and toes, and a sense of weight are 
complained of; finally, absolute loss of sensation is noted, and the parts 
are bleached white and are icy cold to the touch. Those parts which are 
hopelessly frozen, at first white, are then cold and insensible, and after 
reaction either become swollen or discolored, or may shrivel up and 
contract. Gangrene does not usually set in for some little time, it being 
not unusual for the part to look quite well for some days, then to become 
discolored, bluish, dark blue, and finally black. 

Treatment. — The result to be dreaded is the partial or total death of 
tissues which would necessitate amputation of the part or parts. Restore 
the circulation by gently rubbing them with snow or applying friction 
while they are immersed in ice water. This must be done in a room of 
low temperature, the heat of an ordinary bed having been known to cause 
serious trouble. As soon as the general body temperature has returned 
to the member, stimulating friction with soap liniment or alcohol will 
produce excellent results. Then cover the part with cotton. Stimulants 
and warm drink can then be given with caution. 

VERTIGO. 

Synonym. — Dizziness. 

Definition. — Vertigo or dizziness is a subjective state in which the 
individual affected, or the objects about him, seem to be in rapid 
motion, either of a rotary, circular, or a to-and-fro character. 

Gastric or stomach vertigo is the most common variety, and results 
from either dyspepsia or constipation. 

Nervous vertigo is associated with sick or nervous headache and is 
caused by physical or nervous excesses, and also by the immoderate use 
of tea, coffee, alcohol, and tobacco. 

Symptoms. — In all varieties of vertigo the symptom of a sensation 
of objects moving around the patient or the patient moving around 
objects which remain stationary, is present in some degree. The attack 
of giddiness comes on suddenly, with an indistinctness of vision and 
slight confusion of thoughts. The patient may fall unless he grasps 
something to steady himself. Nausea and vomiting with ringing of the 
ears are often associated with the vertiginous sensations. There is 
no loss of consciousness. 



604 ACCIDENTS AND EMERGENCIES. 

The attack is sometimes the result of reading, writing, sewing, 
or other close application of the eyes ; the ordinary symptoms of vertigo 
being preceded by headache, nausea, specks before the eyes, and pain in 
the eyeballs. 

The attack of aggravated vertigo is so sudden and overwhelming at 
times that a person is suddenly thrown to the ground as if struck with 
a blow. 

Treatment. — Place the patient in a dark room in a recumbent posi- 
tion. Put hot applications over the eyes and treat exclusively with a 
milk diet. If the bowels are constipated, a large dose of castor oil will 
be of benefit. In vertigo the habits of the patient must be abstemious-, 
excluding tobacco, tea, coffee, and highly seasoned foods, malt liquors 
and alcohol 

INJURIES OF THE HEAD. 

Injuries of the head are peculiarly important from the fact that 
they may not be limited to the external soft parts and the bones, but 
may involve the brain, the great nervous center, on the integrity of which 
life itself depends. The brain is well protected against ordinary injuries 
or moderate violence. Not only is the head covered with the dense, 
fibrous scalp, but the brain is further incased and defended by the hard, 
bony skull, which is practically a closed box, the thickness of which 
varies in different persons and in different regions. This bony case is 
arched on its upper surface so that blows which would otherwise frac- 
ture and penetrate the skull glance from this curved surface and do but 
little harm. Moreover, the bones are distinctly resilient and elastic, 
yielding under a blow, but springing back to their former position with- 
out fracture, unless the violence be too great. Its elasticity, of course, 
diminishes from youth to age. It is made up also of a number of bones 
united edgewise at the sutures, which, to some extent, diminish the vio- 
lence inflicted upon the skull, although a fracture often crosses the 
sutures. Moreover, a blow of sufficient violence may produce a fracture 
either at the point where it is inflicted, or, occasionally, though rarely, 
at a point opposite to that at which the blow is received. This last form 
of fracture is called fracture by contrecoup, or counterstroke. It should 
be observed that injury by counterstroke is much more frequent in the 
brain than in the skull. There are a number of instances on record 
where a blow received on one side of the head has produced laceration 
of the brain, and even of the middle meningeal artery, on the opposite 
side. 



INJURIES TO THE HEAD. 605 

Inside of this bony case lies the brain surrounded by its membranes 
and more or less steadied and protected by a small fluid normally existing 
in the skull, both on the outside of the convulations and in the ven- 
tricles themselves. Nevertheless, the brain must be looked upon as a 
soft mass of tissue more or less easily lacerated by commotion or shak- 
ing from blows and falls, even without any fracture of the bones. 

Both the brain and its membranes are subject to inflammation, 
which is followed by irritation and later by exudation, swelling, and 
pressure, and the exudate cannot escape through the thick skull and 
scalp except a means of exit be offered by the surgeon. Hence the fre- 
quent need for trephining. The pressure of this exudate may be relieved 
to some extent by the escape of some of the intracranial blood and of 
some of the cerebro-spinal fluid into the spinal canal; but if the pressure 
increases, the functions of the brain must be interfered with and become 
altered or even abolished, while the irritation may cause an exaltation 
of function. This alteration or abolition may apply to the intellectual, 
the sensory, or the motor functions of the brain, so that there may be 
mania or coma, hyperesthesia or anesthesia, and spasm or paresis or 
paralysis. If there is gradually increasing pressure, as from a slowly- 
growing tumor, the brain may accommodate itself to it even for some 
years ; but sudden pressure, as from a fracture or a clot of blood, always 
produces serious symptoms at once. 

Moreover, the interference with function may be general, or, if the 
pressure be local, the alteration or abolition of function will be local, at 
least at the beginning, so that there will be paresis or paralysis of an arm 
or leg or of half the face ; alteration or abolition of speech, either sensory 
or motor; and, if there be inflammation of, or pressure on, the optic 
nerves or tracts, optic neuritis will develop. Sometimes the alteration 
will be obscure and functional rather than organic, so far as we can 
discover, and will produce headache, epilepsy, or insanity, without any 
perceptible change in the brain substance. When pressure is produced 
by a blood clot, caused by a blow with or without fracture, and followed 
not uncommonly by a cyst, epilepsy is not an infrequent sequel. It seems 
also to be probable that the scar resulting from laceration of the brain 
tissue, even in simple fracture or contusion, may be followed by epilepsy. 

While the general anatomical facts here stated have been of course 
long known, yet the localization of function in various parts of the brain 
has been proved and accepted only in the last thirty years, while cerebral 
surgery founded upon it practically began only in 1884. Broca in 
France ; Goltz, Fritsch, and Hitzog in Germany ; and Horsley in England, 



6o6 ACCIDENTS AND EMERGENCIES. 

have done the principal work in solving the neurological problem, while 
Macewen and Horsley in England have created a new department in 
surgery. Until a few years ago the skull was regarded as a region so 
dangerous that Dante's motto might have been an appropriate warn- 
ing. "Abandon hope, all ye who enter here;" and though there were 
occasional accounts of extraordinary and unexpected recoveries from 
accident, yet purposeful interference with the brain and its membranes 
was never to be thought of except where compound fracture with serious 
brain symptoms made it absolutely needful, and then it was undertaken 
with reluctance and fear. This was due, first, to our ignorance of the 
localizing value of the different parts of the brain, which differ from one 
another in function as much as do the different viscera of the abdomen; 
and, secondly, to our ignorance of the fact, now amply proved, that if 
we employ the rigid antiseptic details practised by Macewen and fully 
formulated by Horsley so late as 1886 and 1887, we can invade the 
skull cavity with far less danger than was formerly thought possible. 
Inflammation and suppuration should rarely follow, provided antiseptic 
precautions are strictly followed. 



APPARENT DEATH FROM DROWNING, 
STRANGULATION, OR SUFFOCATION. 

Act quickly and persevere for hours, if necessary. 

Do not waste time by removing the patient unless the weather is 
severe and inclement. 

Send by the quickest means for medical assistance, clothing, blankets, 
and supplies. 

Place the patient face downwards, forehead resting on bent arm for 
protection. 

Pull the tongue forward, using forceps or fingers for the purpose. 

Let any fluids flow from the mouth and throat. 

See that in handling the body the tongue does not fall back so as to 
close up the passage of the throat and prevent the entrance of air into 
the lungs. 

Try to excite breathing by : — 

Turning the patient to one side. 

Apply a pinch of snuff to the nostrils, or use other convenient methods 
of exciting sneezing. 



APPARENT DEATH. 607 

Rub the face until it becomes warm. 

Then dash colcl water in the face. 

If this is not successful, try artificial respiration. 

Sylvester's Method. 

Clear the throat of all mucus, etc. 

Hold the tongue forward in the mouth, — an assistant can do this. 

Use a handkerchief in holding the tongue to prevent slipping back. 

Lay the patient out straight on his back on a level surface. 

Loosen the clothing around the chest and abdomen. 

Put a folded coat under the head so as to raise it slightly. 

Kneel or stand, according to situation, at the patient's head. 

Bend the arms tightly at the elbows. 

Grasp the forearm near the elbows. 

Firmly press the elbows against the lower part of the chest for three 
or four seconds. See Fig. 102. 

Sweep the patient's arms at full length outward and upward along- 
side of the head until the hands touch. See Fig. 103. 

Pull firmly up on the arms so as to expand the chest for a few seconds. 

Restore the bent arms to the first position and press again upon the 
walls of the chest for a few seconds. 

You are thus imitating the rising and falling of the chest as it occurs 
in natural breathing. 

Repeat at the rate of about twelve or fifteen times a minute, until 
natural respiration recommences. 

Continue after breathing begins and give the process such assistance 
as it requires until it goes on easily. 

When one operator gets tired have another take his place without 
interruption. 

It may be necessary to keep up the method for two hours or longer. 

Meanwhile let another assistant apply dry warmth by such means 
as hot blankets to the body. 

Rub the surface of the body briskly. 

Rub the limbs upward, not downward, using a towel if at hand, if 
not, a handkerchief or the hand. 

JPut dry clothing around the patient in drowning cases, letting 
bystanders contribute coats and waistcoats for the purpose. 

The first signs of returning life are usually a sigh, or a gasp, a slight 
movement or palpitation of the heart. 

Do not relax the efforts on the first signs of returning life. Rather 



6o8 



ACCIDENTS AND EMERGENCIES. 




Fig. 102. Artificial Respiration. 
Position I. Sylvester's Method. 




Fig. 103. Artificial Respiration. 
Position II. Sylvester's Method. 



APPARENT DEATH. 609 

redouble the efforts. Many a life has been sacrificed by relinquishing the 
efforts just at this point. 

As soon as the patient can swallow give a teaspoonful or two of 
warm wine or brandy and water. Do not give him raw liquor as it may 
cause choking. 

When revived, place the patient in a bed, well supplied with warm 
blankets. 

Keep him perfectly quiet and resting as much as possible. 

Method When the Arm is Broken or Injured. — The method of 
exciting respiration by artificial means just described cannot be practised 
when the arm is broken, dislocated, or otherwise injured. In such 
cases do not take time to set the limb, reduce the dislocation or bandage 
a wound, unless there is hemorrhage. 

Proceed at once as follows : — 

Strip the patient from the neck to the waist. 

Place him flat on his back. 

Raise the chest somewhat by putting a rolled-up coat under his 
shoulders. 

Stand astride of the patient, facing his head. 

Press upon the body along the lower or floating ribs, where the 
chest can be most easily compressed. 

Keep the fingers spread well apart, so as to cover as much area 
as possible. 

Squeeze together the two sides of the chest. 

The pressure must be very considerable : but care must be taken that 
no injury is done to the parts. 

A rib may be broken by exercising too great force: and the thumb 
may be too strongly pressed into the region of the stomach or abdomen. 

Maintain the position shown in Fig. 104 for two seconds. 

Then, with a quick, springing motion, remove all pressure, taking 
the hands completely from the body. 

Where the arms are not injured, they may be grasped and raised 
upwards and downwards at right angles to the body so as to bring 
about the alternate contraction and expansion of the chest. This method, 
which is rather less effective than the others, is shown in Fig. 105. 

There are many other methods, but they require more or less skill 
to perform them correctly. Those given above are the simplest and at 
the same time most likely, if persisted in, to bring about beneficial results 
at the hands of an unskilled person. 



10 



ACCIDENTS AND EMERGENCIES. 




Fig. 104. Artificial Respiration. 
Compressing the chest. Howard's Method. 




Fig. 105. Artificial Respiration. 
Raising and lowering arms. Third Method. 



POISONING. 611 

POISONS AND THEIR ANTIDOTES. 

In treating cases of poison remember the following points : — 

First. — Send immediately for a physician. 

Second. — Wash out the stomach, or produce vomiting. 

Third. — Give the proper antidote after the stomach has been washed 
out. 

Fourth. — A prompt cathartic (Epsom salts, castor oil, olive oil, 
sweet oil) to eliminate the poison from the bowels. 

Fifth. — Treat dangerous symptoms, if any arise as a result of the 
poison. 

Sixth. — If the heart fails give stimulants. 

Seventh. — If respiration is embarrassed douche the chest alternately 
with hot and cold water. Perform artificial respiration. 

To empty the stomach, any long rubber tube, to one end of which a 
funnel may be attached while the other end slightly oiled is passed 
through the mouth into the stomach, will serve as a stomach tube. Hold- 
ing the funnel above the mouth, warm water or strong mustard water 
may be poured through the funnel and tube into the stomach. Then, 
by lowering the funnel end to below the level of the stomach and moving 
the tube up and down a few times, the stomach will become so irritated 
as to throw out the water and some of the poison. Raise the funnel 
end and pour in warm water; lower the tube as before. Repeat this 
process until the fluid from the stomach returns perfectly clear. If 
a tube is not at hand, produce vomiting as speedily as possible by 
repeatedly drinking warm water, or strong mustard water, or by tickling 
the throat with the finger or a feather. 

IRRITANT POISONS 

Are arsenic, antimony, mercury, iodine, chlorine, ammonia, canthar- 
ides, alkalies, and strong acids — cause intense burning pain in throat 
and stomach. Vomiting must be produced. After the stomach has 
been evacuated of a poison, take oil, or whites of several eggs, flaxseed 
tea, slippery elm tea, gum arabic in solution, or gelatine. 

NARCOTIC POISONS 

Are opium, chloral, alcohol, belladonna, aconite, strychnia, carbolic 
acid — produce deep sleep and insensibility, which must be counteracted 
by shocks to the nervous system by dashing cold water on the spine and 



612 ACCIDENTS AND EMERGENCIES. 

chest, also administer strong coffee and other stimulants. Keep patient 
awake and moving at any cost. 



EMETICS TO BE USED IN CASES OF POISONING. 

1. Copious draughts of warm water. 

2. A tablespoonful of mustard in a glass of warm water; repeat 
until effective. 

3. Sulphate of zinc : twenty or thirty grains in half a glass of warm 
water. Repeat every fifteen minutes until effective. Do not give it if 
salt and water has been given. 

4. Sulphate of copper : five to seven grains in one quarter glass of 
water. Not to be repeated. This emetic should be used only in cases 
of phosphorus poisoning and then with caution. 

5 . Alum : a heaping teaspoonf ul for a child, a tablespoonful for an 
adult, given in a little water. 

6. Turpeth mineral : The dose for a child one to two grains, re- 
peated, if necessary, in fifteen minutes. Dose for an adult two to five 
grains in a little warm water. If five grains are given without effect, do 
not repeat the dose, but try other emetics. 

7. Ipecac: Is inferior to other emetics but may of necessity be 
used. Syrup of ipecac or wine of ipecac in from one-half to one tea- 
spoonful dose is the emetic for an infant. The fluid extract of ipecac, 
thirty or forty drops, the emetic for an adult. Fifteen to thirty grains 
of the powder is given in half a glass of warm water. 

The Heart Stimulants to be* employed are brandy, whisky, strychnia, 
one-sixteenth to one-thirtieth of a grain; or tincture of digitalis, 20-drop 
doses by the mouth ; aromatic spirits of ammonia, one teaspoonful dosage 
in water; ammonium carbonate, two to ten grains in water; strong, hot 
coffee. 

Respiratory Stimulants are strychnia sulphate, one-sixtieth to one- 
thirtieth of a grain in water hypodermically or by the mouth ; ammonium 
carbonate, two to ten grains in water ; sulphate of atropine, one-hundred- 
fiftieth to one-seventy-fifth of a grain in water hypodermically, or by the 
mouth. 

Emollients and Demulcents are used to protect the mucous mem- 
branes. They are flaxseed or linseed oil, olive oil, flaxseed or linseed 
tea, almond oil, licorice, glycerine, starch paste, vaseiine, whites of eggs. 

Acetanilid. — Emetics, recumbent position, rest, stimulants by the 
stomach, hypodermic injection, or by the rectum. 



POISONING. 613 

Acids (Mineral Acids). — Do not give emetics. Neutralize the 
poison with soapsuds, washing soda, chalk, magnesia, plaster of the 
wall in emergency, then cautiously wash out the stomach and after- 
wards give emollient drinks such as oils, milk, whites of eggs, to protect 
the mucous membranes. Stimulants to overcome depression, and mor- 
phine, one-eighth to one-quarter grain, or twenty drops of laudanum, 
to relieve pain. If acid is in the lungs, let the patient inhale fumes of 
ammonia. 

Acid, Carbolic. — Any soluble sulphate such as Epsom salts, one to 
three ounces, or Glauber's salts; alcohol, two to six ounces in any form, 
except wood alcohol, to neutralize the acid. Then produce vomiting. 
White of Qgg ; olive oil, two to four ounces, in one pint of water. 

Acid, Hydrocyanic. — Emetics ; then give twenty grains of carbonate 
of potash in an ounce of water followed immediately by a mixture of 
ten grains of copperas (sulphate of iron) and one teaspoonful of tincture 
of iron in an ounce of water. Douche to the face and chest with cold 
water. Fresh air, inhalations of ammonia, artificial respiration, stimu- 
lants, artificial heat. 

Aconite. — Emetics, recumbent position, mustard over the heart, stim- 
ulants; rub the patient vigorously, apply external heat, give demulcents, 
artificial respiration. 

Ammonia. — Do not use stomach tube, for fear of perforating the 
stomach; produce vomiting by other means. Give vinegar, lemon juice, 
and demulcent drinks to protect the mucous membranes. If the patient 
is overcome by inhalation of the gas, let him smell hydrochloric acid or 
acetic acid. Relieve pain by one-eighth to one-fourth grain of morphine, 
or twenty drops of laudanum. 

Antimony. — Produce vomiting, give strong tea, tannic or gallic acid 
or catechu as an antidote. Demulcent drinks, to protect the mucous 
membranes. Morphine, one-eighth to one-fourth grain, or twenty drops 
of laudanum, to relieve pain. Stimulants, warm blankets, and hot water 
bottles. 

Antipyrine. — Treat as for acetanilid poisoning. 

Arsenic. — Prompt vomiting; then give arsenic antidote to be found 
in drug stores as "Hydrated Oxide of Iron, with Magnesia." Demulcent 
drinks; purgatives, preferably castor oil; morphine, one-eighth to one- 
quarter grain, or twenty drops of laudanum, to relieve pain. Stimulate 
and apply artificial heat. Large quantities of tepid, greasy, or soapy 
water; dishwater or salt and water; one-half pint of olive oil in one 
pint of limewater ; linseed meal poultices to the abdomen. 



614 ACCIDENTS AXD EMERGENCIES. 

Atropine. — Treat as for belladonna poisoning. 

Barium Salts. — Treat as for poisoning by lead salts. 

Belladonna. — Emetics, given in strong tea; apply cold to the head; 
give enema of strong, hot coffee. Sweet spirits of niter in teaspoonful 
dosage to eliminate the poison. Morphine, one-fourth grain dose, or 
twenty drops of laudanum, to antidote the poison and relieve pain. Per- 
form artificial respiration ; give inhalations of ammonia ; apply artificial 
heat. 

Bee Sting. — See "Sting of Bees." 

Cantharides (Spanish Fly). — Emetics., copious demulcent drinks, 
such as gruel, flaxseed tea, elm bark tea, barley or rice water. Do not 
give oils. Large draughts of water to flush the kidneys. Morphine, one- 
eighth to one-quarter grain, or twenty drops of laudanum, to relieve 
pain. Stimulants; artificial heat. 

Chloral. — Emetics ; strong coffee in quantity ; strychnia, one-thir- 
tieth of a grain, and atropine, one-hundredth of a grain, as antidotes. 
Apply electricity ; slap the patient with a wet towel or palm of the hand. 
Shake him vigorously to keep him awake. Perform artificial respiration ; 
apply cold to the head, and give inhalations of ammonia. 

Chloroform. — If inhaled to excess, lower head and pull tongue for- 
ward to admit plenty of fresh air; perform artificial respiration. If 
swallowed, empty the stomach either with tube or emetic. Give baking 
soda solution — tablespoonful to tumblerful of water. Repeat two or 
three times. Douche chest with hot and cold water alternately. Stimu- 
late. Inhalations of ammonia, perform artificial respiration; supply 
artificial heat. 

Coal Gas and Choke Damp. — Open the windows; supply plenty 
of fresh air : perform artificial respiration ; douche the chest with hot 
and cold water alternately ; cold effusions to* the face ; stimulate ; slap the 
chest over the heart with the palm of the hand; give inhalations of 
ammonia. 

Cocaine. — Give emetic; give tannic, or gallic acid, twenty grains in 
one-quarter glass of water, then, wash out the stomach or give emetic 
again. Stimulate; perform artificial respiration; give inhalations of 
ammonia. 

Codeine. — Treat as for opium poisoning. 

Colchicum. — Give emetics and cathartics ; follow by demulcent 
drinks ; give inhalations of ammonia ; morphine, one-eighth to one-fourth 
grain; or twenty drops of laudanum. Keep up external heat to abdo- 
men and extremities. 



POISONING. 615 

Conium. — Give emetics ; follow by strong tea. tannic or gallic acid 
(twenty grains in a little water), and again give emetic. Next, give 
plenty of demulcents and stimulate. Perform artificial respiration. 

Copper Sulphate. — If a copper coin is swallowed avoid liquids, give 
constipating foods (dry diet) and it will pass the bowels without serious 
injury. If copper in other forms is swallowed (as salts of copper), give 
emetics, whites of eggs in water or milk and the ferro-cyanide of potas- 
sium (fifteen grains in a glass of water), or soapsuds may be given and 
wash out the stomach again. Relieve pain with morphine, one-eighth 
to one-fourth grain, or twenty drops of laudanum ; ultimately give ten or 
fifteen grains of iodide of potash in water every three hours until symp- 
toms of cold in the head appear. 

Corrosive Sublimate (Bichloride of Mercury). — Treat as for cop- 
per poisoning. 

Creosote. — Treat as for carbolic acid poisoning. 

Croton Oil. — Give emetics ; wash out the stomach ; give demulcent 
and emollient drinks: morphia, one-eighth to one-fourth grain, or 
twenty drops of laudanum, to relieve pain and arrest bowel movements. 

Cyanide of Potash. — Treat as for hydrocyanic acid poisoning. 

Digitalis. — Give emetics; then tannic or gallic acid (Twenty or 
thirty grains in a little water), or draughts of strong tea. and wash out 
the stomach again. Tincture of aconite in two or three drop dosage (not 
to be repeated), or laudanum, twenty drop dosage, if the patient has been 
accustomed to the use of digitalis ; stimulate ; keep the patient in the 
recumbent position, for fear of heart failure. 

Elaterium. — Treat as for colchicum poisoning. 

Ergot. — Give emetics: follow by tannic or gallic acid (twenty grain 
dosage in a little water), or oak bark decoction: stimulate and give 
nitroglycerine, one-hundredth of one grain, as an antidote. Supply arti- 
ficial heat and rub the patient briskly. 

Ether. — Treat as for chloroform poisoning. 

Fly Poison. — Treat as for arsenic poisoning. 

Fish Poisoning (Ptomaine Poisoning — poisoning from milk, 
cream, or ice cream). — Give emetics: followed by gallic or tannic 
acid (twenty grain dosage in a little water), and again give emetic. 
To control pain and diarrhoea, give morphia, one-eighth to one-fourth 
grain, or twenty drops of laudanum, adding to either of these fifteen 
or twenty drops of tincture of capsicum or a few grains of red pepper. 
Bathe with alcohol and tepid water (equal parts) to reduce fever. 
Sweet spirits of niter in one teaspoonful dosage every three hours 



616 ACCIDENTS AND EMERGENCIES. 

to relieve the kidneys. To overcome the nausea and vomiting, after the 
stomach has been thoroughly washed out give bismuth subnitrate, ten 
grains in one teaspoonful cinnamon water. Repeat every two hours. 

Gold. — Treat as for copper poisoning. 

Hyoscyamus. — Treat as for belladonna poisoning. 

Insect Bites. — Treat as for sting of bees. 

Ink; Aniline Dyes. — Treat as for acetanilid poisoning. 

Iodine. — Give emetics, demulcent drinks, starch or flour water. Re- 
lieve pain with morphia, one-eighth to one-fourth grain dosage, or 
twenty drops of laudanum. Inhalations of ammonia. Supply artificial 
heat. 

Laudanum. — Treat as for opium poisoning. 

Lead Salts. — Give emetics, followed by dilute sulphuric acid, thirty 
drops, or tablespoonful of Epsom salts or Glauber's salts in water, and 
again give emetics. Give demulcent or emollient drinks, following with 
morphia, one-eighth to one-fourth grain dosage, or twenty drops of 
laudanum in water, to control pain. Supply artificial heat, particularly 
over the bowels. In cases of chronic lead poisoning, put the patient on 
iodide of potash, iodide of lime, or iodide of soda, fifteen to twenty grain 
doses three times daily, to promote elimination. 

Lobelia. — Give emetics; then tannic or gallic acid (twenty or thirty 
grains in water) ; then again wash out stomach. Stimulate with 
strychnia and alcohol ; give cathartic, preferably castor oil ; relieve pain 
with morphia, one-eighth to one-fourth grain, or twenty drops of 
laudanum. 

Matches. — Treat as for phosphorus poisoning. 

Morphine. — Treat as for opium poisoning. 

Mushrooms. — Give emetic ; purge with castor oil ; and wash out the 
bowels with warm soapsuds injection. Give atropine, one hundredth of 
a grain hypodermically, or tincture of belladonna, twenty drops in water, 
every half hour by the mouth, until relieved or until dryness of the throat 
is produced. Stimulate and supply artificial heat. 

Mercury. — Treat as for copper poisoning. 

Nicotine. — Treat as for tobacco poisoning. 

Nitrous Oxide (Laughing Gas). — Treat as for chloroform poison- 
ing. 

Nux Vomica. — Give emetic, and wash out the stomach repeatedly. 
Give tannic or gallic acid (twenty grain dosage in water) ; strong tea or 
decoction of oak bark ; and wash out the stomach again. Draw off the 
urine through a catheter. Give sweet spirits of niter in teaspoonful 



POISONING. 6r 7 

dosage every three hours. To control spasms, give thirty grains of 
chloral and sixty grains of bromide of potash in water or milk, and give 
inhalations of chloroform or ether. Perform artificial respiration. 

Opium. — Give emetics; then tannic or gallic acid (twenty or thirty 
grains in water), or large draughts of strong tea, and again give emetics; 
perform artificial respiration; apply cold water to face and chest. Give 
atropine one-hundred-twentieth grain hypodermically, every fifteen 
minutes for three doses; strychnia, one-thirtieth grain; and strong, hot 
tea or coffee should be given. Give cathartic; draw off the urine fre- 
quently. Keep the patient awake by applications of electricity. 

Oxalic Acid. — Wash out the stomach; give limewater, chalk, car- 
bonate or oxide of magnesia to neutralize the acid. Wash out the 
bowels ; give water by the mouth freely. Apply artificial heat. 
Paris Green. — Treat as for arsenic poisoning. 
Phosphorus (Rat Poison). — Give emetics, such as copper sulphate, 
five grains in a little water every five or six minutes until effective. Wash 
out the stomach with oil of turpentine, one teaspoonful to a pint of 
water; give limewater to overcome the action of the poison. Draw 
off the urine frequently. Act upon the bowels and kidneys by giving 
two tablespoonfuls of Epsom salts in a glass of water, to which add a 
teaspoonful of sweet spirits of niter. Give neither oils nor fats as 
phosphorus is soluble in them. 

Poison Ivy. — An external poisoning due to contact with the poison 
ivy vine. Cover the parts with ichthyol and vaseline (equal parts), or 
use saturated solution of lead acetate in dilute alcohol, and rub well 
over affected parts for several days ; or, use acetozone, fifteen grains dis- 
solved in a quart of warm water. Let stand for two hours. Then apply 
to affected parts cloths wet with this solution, and keep the clothi con- 
stantly wet. Whatever local treatment is employed, it must be con- 
tinued for some days. Keep up nutrition ; relieve the nervous irritability 
by administration of strong coffee and strychnia, one-thirtieth of a grain, 
every four hours for an adult. 

Rat Poison. — Usually contains arsenic and phosphorus and the treat- 
ment should be that for arsenic and phosphorus poisoning. 

Silver Compound. — Give emetic, and wash out the stomach with 
strong brine (two teaspoonfuls of common salt to one pint of warm 
water) . Give plain water freely ; whites of eggs ; milk ; demulcent drinks. 
Relieve pain with morphia, one-eighth to one-fourth grain, or twenty 
drop dosage of laudanum. 

Snake Bite. — Suck the wound clean as possible, or cause it to bleed 



618 ACCIDENTS AND EMERGENCIES. 

freely, and apply strong ammonia; or, inject permanganate of potash 
solution (ten grains to a pint of water). Stimulate; give inhalations of 
ammonia and aromatic spirits of ammonia in teaspoonful dosage inter- 
nally. Perform artificial respiration, if required. 

Soda. — Treat as for ammonia poisoning. 

Stings of Bees, Insect Bites, etc. — Extract the sting; apply onion 
poultice or raw onion or ammonia water; baking soda or the following: — 

Turpentine, i ounce. 

Sal Ammoniac, 2 drains. 

Compound Soap Liniment, to make, 5 ounces. 

Mix, and apply locally. 

Stramonium (Thorn Apple). — Treat as for belladonna poisoning. 

Sulfonal. — Treat as for chloral poisoning. 

Strychnine. — Treat as for nux vomica poisoning. 

Tartar Emetic. — Treat as for antimony poisoning. 

Thorn Apple. — Treat as for belladonna poisoning. 

Tobacco. — Give emetics, followed by tannic acid (thirty grains in a 
little water), and wash out the stomach with warm water. Stimulate; 
give water freely, and sweet spirits of niter in teaspoonful dosage every 
three hours. Keep the patient quiet in a recumbent position ; apply arti- 
ficial heat to the body and lower extremities, and cold to the head. 

Vitriol (Blue). — Treat as for copper sulphate. 

Vitriol (White). — Treat as for zinc salts. 

White Precipitate. — Treat as for copper sulphate poisoning. 

Wood Alcohol. — Treat as for alcohol poisoning. 

.Zinc Salts. — Give emetic, or wash out the stomach with baking soda 
or washing soda (four drams to a pint of water). Give tannic acid or 
gallic acid (twenty or thirty grains to a wineglass of water), and wash 
out the stomach with warm water. Then give warm demulcent or 
emollient drinks; relieve pain with morphia, one-eighth to one-fourth 
grain, or twenty drops of laudanum. Apply external heat, particularly 
over the bowels and lower extremities. 



POISONOUS PLANTS OF WOOD, FIELD, AND GARDEN. 

It is remarkable that in view of the very large number of painful 
and fatal cases of poisoning by plants that occur every year in this 
country, no attempt has been made to place accurate and full information 
on the subject within the reach of the public. 



POISONOUS PLANTS. 619 

Ignorance concerning the poisonous plants causes loss of human life, 
destruction of whole herds of cattle, enormous financial loss, and much 
suffering and distress from innumerable cases not attended by fatal 
results. 

It is found by inquiry and study of the subject that a great deal of 
what is considered accurate knowledge on the subject is very imperfect; 
much of it is traditional ; many plants which are perfectly harmless are 
supposed by many to be extremely dangerous; and some that are emi- 
nently dangerous are not well enough known to be recognized when 
seen. 

The confusing variety of names by which one and the same plant is 
known in different localities, and the great number of different names 
given to it in the same locality, only add to the already too great possi- 
bility of fatal mistakes. 

The danger is also greatly increased by the fact that many persons 
are very susceptible to the effects of poison in plants, while others enjoy 
a sort of immunity from it and can handle plants of this sort with perfect 
safety. So that what is a poisonous plant to one person in a locality is 
not so regarded by others. The Poison Ivy is, perhaps, one of the com- 
monest examples of this sort. Some are poisoned by it when passing in 
the vicinity where it grows, without coming in contact with it. Others 
can handle it with perfect safety. 

But the very great harm that such plants do lies in the fact that so 
many people do not know the dangerous plants when they meet them. 
The result is that these persons are in a state of constant dread of every 
unknown plant or they unconsciously expose themselves to danger at 
every turn. Of what protective advantage is it to one to know that 
Poison Ivy is a very dangerous and painful plant with which to come in 
contact if one does not know the plant when one sees it ? It is this very 
ignorance that has caused great suffering to some; while others have 
rooted out the beautiful and perfectly harmless Virginia Creeper from 
their yards and gardens with needless and ridiculous fear under the 
impression that it was the offender. The knowledge that Poison Ivy 
never has five leaflets would have saved them much anxiety and preserved 
to them a highly decorative climbing plant. 

Common Causes of Poisoning. — Of the very great number of cases 
of poisoning by plants which have been thoroughly investigated, it is 
found that the common causes of poisoning by them result from : — 

1. An overdose of teas and infusions made from such plants as 
are used as domestic remedies. 



620 ACCIDENTS AND EMERGENCIES. 

2. Mistaken identity, such as using aconite seeds for anise seeds; 
aconite leaves for parsley; and aconite root for horse-radish. 

3. The attractiveness and beauty of flowers, berries, leaves and 
roots; such as caused the death of four children recently in New York 
city by eating the seeds of a Jimson Weed, which they found growing 
in a vacant lot. 

4. Children making whistles from the hollow stem of the Wild 
Parsnip and taking that part of the plant into the mouth while blowing 
upon it. 

5. Curiosity; such as caused one man to nibble upon the root of the 
Oregon Water Hemlock, with fatal results. 

Protective Measures. — The two very simple means which self- 
defense and parental care suggest are to learn to know the dangerous 
plants with positive certainty and then to eradicate them. To this end 
are presented very accurate drawings of the several plants from life, 
simple and clear descriptions of them in plain language, and particulars 
of the poisonous effects, with proper treatment. 

The law of England holds a person responsible for any damage 
(even in trespass) which follows from the possession or cultivation of 
poisonous plants. For instance, a jury awarded damages recently to 
the owner of a horse which was poisoned by eating of the branches of 
a yew tree which hung over the fence of an adjoining yard. 

In New York the directors of a cemetery were compelled to pay 
$3,500 damages as a result of poisoning by poison ivy, which had been 
allowed to grow within the grounds. 

Some states, such as Colorado, are paying large bounties for the 
extermination of the loco weed, which is so destructive to animals in 
the West. Between the years 1881 and 1885, Colorado paid out over 
$200,000 as bounties. 

There are many instances of legal complications which confront leg- 
islators who attempt to deal with the matter. That there are hardships 
against the enactment of a stringent law of responsibility is very plain. 
Yet, on the other hand, when one remembers the tremendous loss of life 
and property resulting from the cultivation of such plants, one is almost 
inclined to forget the lesser hardship. 

FLY AMANITA. 

Botanical Name. — Amanita Mnscaria (L.) Fr. 

Common Names. — Fly fungus, fly agaric ; fly killer, deadly amanita ; 
false orange amanita. 



POISONOUS PLANTS. 



621 



Habitat. — Found in pine and oak forests from spring to autumn. 
Abundant in many localities throughout the United States. 

Description. — From four to 
sixteen inches high; when 
young, the cap is convex on 
top; later, it becomes flat or 
even concave; cap covered 
with warts; in color it ranges 
from white through all shades 
of yellow to a bright red; the 
gills under the cap are white. 

Poisonous Parts of the 
Plant. — An alkaloid called 
muscarine present in all parts 
of the plant. An effective fly 
poison. 

Causes of 
Plant is mistaken 
mushroom. 

Symptoms of Poisoning. 



Poisoning. — 
for edible 




Fig. 106. Fly Amanita (Amanita Mus- 
caria). One-fourth Natural Size. 

-Heart's action is slow: breathing- is 



difficult; profound stupor; cold sweats; giddiness; double vision; lock- 
jaw; death ensues in from eighteen hours to two 
or three clays. 

Treatment. — Heart's action is to be increased 
and sustained by hypodermic injections of from 
1- 1 00 to 1-50 of a grain of atropine. Mustard 
is the best emetic; if this fails, give hypodermic 
injections of apomorphine. Two grains of per- 
manganate of potash in a one per cent alkaline 
solution may be given to decompose the poison: 
follow it with olive oil, and an enema of warm 
water and turpentine. 




DEATH CUP. 

Botanical Name. — Amanita Phalloides. 

Common Names. — Poison amanita; bulbous 
amanita. 

Habitat. — Found abundantly in pine forests, 
also on edges of woods in Eastern and Middle States, California, and 
Washington, D, C. 



Fig. 107. Death Cup 
(Amanita Phalloides). 
One-fourth Natural 
Size. 



622 



ACCIDENTS AND EMERGENCIES. 



Description. — From three to six or eight inches high ; cap is smooth 
and satiny ; convex at first, later, flat or slightly concave ; white or straw 
yellow, green, light brown, yellow, or spotted; stem white and nearly 
smooth; gills are white, and base is bulb-like. 

Poisonous Parts of Plant. — The most poisonous of all the fungi. 
Phallin or toxalbumin, an alkaloid found in all parts of the plant. 

Symptoms. — From nine to fourteen hours after eating there are 

pains; cramp in the legs, con- 
vulsions, lockjaw, pupils dilated; 
nausea; vomiting; "rice water" 
diarrhoea; and, usually, death in 
from two to four days. 

Treatment. — There is no 
known antidote for phallin. 
Empty the stomach and bowels, 
give hypodermic injection of 
atropine and similar treatment as 
in poisoning by fly amanita. 
The last resort is transfusion of 
the blood with solution of com- 
mon salt or blood taken direct 
from some warm-blooded animal. 

AMERICAN FALSE 
HELLEBORE. 

Botanical Name. — Veratrum 
Viride. Ait. 

Common Names. — American 
white hellebore; white hellebore; 
false hellebore; swamp hellebore; 
Indian poke; meadow poke; poke 
root; Indian uncus; puppet root; 
earth gall ; crow poison ; devil's 
bite ; duck retter ; itch weed ; bugbane ; wolfbane ; bear corn. 

Habitat.- — Abundant in wet meadows and along mountain brooks; 
found very generally throughout the United States. 

Description. — From two to seven feet high; large, stemless leaves; 
fleshy root from one to three inches long ; yellowish green, small flowers 
occurring from May to July. 

Poisonous Parts of the Plant. — Several alkaloids, such as jervine, 




Fig. 108. False Hellebore (Veratrum 
Viride). One-third Natural Size. 




IjADY'S SUPPER (Cypripedium hirsutum). 



POISONOUS PLANTS. 



623 



cevadine, and veratrine, are found in the rhizome or fleshy root. 

used as food 



marigold and 



The 

with 



plant: lias been mistaken for marsh 
fatal results. 

Sympto m s. — Burning pain in 
the mouth and throat ; flow of saliva ; 
retching; vomiting; diarrhoea, 
headache, dizziness; faintness; low 
pulse; difficulty in breathing; death 
ensues from heart paralysis. 

Treatment. — Prompt emetics ; 
stimulants, such as brandy or strong 
coffee; ether or opium; keep the 
hands and feet warm, and let the 
patient lie flat on his back. 

LADY'S SLIPPERS. 

Botanical Names. — Cypripedium 
reginae, Cypripedium hirsutum, 
Cypripedium parviilorum. 

Common Names. — Showy lady's 
slipper; whip-poor-will shoes; nerve 
root; female nervine; larger yellow 
lady's slipper; yellow moccasin; 
moccasin flower; nervine; American 
valerian; yellows; Noah's Ark; yel- 
low umbil; Indian shoe; slipper 
root; Venus's cup; Venus's shoe; 
umble; male nervine; monkey flow- 
er; smaller yellow lady's slipper. 

Habitat. — Peat bogs and swamps 
from Maine to Minnesota and south- 
ward to Georgia and Missouri. 

Description. — From one to two feet high; leaves large and parallel- 
veined; flowers white, striped with purple, or yellow, or yellow and 
brown in the last two species. Flowers of the first species appear from 
June to September ; those of the latter two, in May or June. 

Poisonous Parts of the Plants. — An oil secreted by the glandular 
hairs which cover the stems and leaves. 

Symptoms. — Very similar to those of poisoning by poison ivy. 

Treatment. — No specific antidote is known. 




Fig. 109. Aconite (Aconitum Colum- 
bianum). (a) Flowering Plant; {&) Cap- 
sule, both One-third Natural Size. 



624 



ACCIDENTS AND EMERGENCIES. 



ACONITE. 



Botanical Name. — Aconitum co- 
lumbianum. 

Common Names. — Monkshood ; 
friar's cap; wolfsbane; iron hat; 
storm hat; blue weed. 

Habitat. — Moist, open woods ; 
banks of brooks, and on mountain 
sides. Found very generally over 
the United States. 

Description. — From two to six 
feet high; single stem; showy blue 
flowers growing in a terminal 
cluster. 

Poisonous Parts of the Plant. — 
All parts, but, especially, the seeds 
and roots. 

Symptoms. — Burning sensation 
at the tip of the tongue ; choking 
or constriction of the throat; 
breathing becomes slow; a tingling 
or prickling sensation over the body ; 
headache; pains in the abdomen. 

Treatment. — Atropine, digitalis, 

and nitrite of amyl in the hands of 

a physician prove effective. Give 

emetics and stimulants. Artificial 

respiration is to be resorted to and, if necessary, maintained for two 

hours or more. The patient must lie down during the entire treatment. 




Fig. 1 10. Dwarf Larkspur (Delphin- 
ium Tricorne). One-third Natural 
Size. 



LARKSPURS. 

Botanical Names. — Delphinium tricorne; Delphinium geyeri; Del- 
phinium menziesii; Delphinium recurvatum; Delphinium trolliifolium. 

Common Names. — Dwarf larkspur; stagger weed; larkspur; pur- 
ple larkspur; cow poison. 

Habitat. — Clayey soil, open woods, prairies, hillsides, moist soil, 
and shady places. 

Description. — There are twenty-five species, with many common 
characteristics. They are usually erect, with much dissected, or lobed. 



POISONOUS PLANTS. 



625 



leaves and bear a long cluster of showy flowers. These are commonly 
blue and have a spur-like growth upon them. The plants vary in height 
from six to twelve inches, as seen in the dwarf larkspur, up to two 
feet or more. The species are generally found throughout the United 
States. 

Poisonous Parts of the Plants. — The plants are very poisonous to 
cattle and great loss, especially among sheep, has resulted. The leaf 
is the most poisonous part. 

Treatment. — Emetics and 
stimulants, followed by artificial 
respiration. Atropine, digitalis, 
and nitrite of amyl have pro- 
duced good effects. 

BLACK CHERRY. 

Botanical Name. — P r u n u s 

scrotina. 

Common Names. — Wild black 
cherry; wild cherry; rum cherry; 
whisky cherry. 

Habitat. — Forests, woods, and 
open country very generally 
throughout the United States. 

Description. — A tree from 
sixty to eighty feet high : bark, 
thin, reddish-brown, and scaly; 
leaves, tapering, saw-edged; flow- 
ers, small, slightly bitter and as- 
tringent, but rather agreeable. 

Poisonous Parts of the Plants. 
— The wilted leaves generate 
prussic acid, the deadliest of 
poisons. Children occasionally die from swallowing the fruit whole or 
from eating the kernels. 

Symptoms. — An odor of prussic acid or bitter almonds on the breath; 
difficulty in breathing ; low pulse ; numbness ; fright ; protruding eyeballs ; 
convulsions; death from lung paralysis. 




Fig. hi. Black Cherry (Prunus Sero- 
tina). One-third Natural Size. 



626 



ACCIDENTS AND EMERGENCIES. 



Treatment. — Death follows rapidly and relief must be promptly 
afforded. Emetics; wash out the stomach with peroxide of hydrogen; 
a solution of cobalt nitrate ; artificial respiration ; oxygen gas, and trans- 
fusion of blood. 



KENTUCKY COFFEE TREE. 

Botanical Name. — Gymnocladns 
dioica. 

Common Names. — Coffee tree ; 
American coffee bean; Kentucky 
mahogany; nicker tree; bonduc; 
chicot. 

Habitat. — Rich soil along rivers 
from Nebraska to Arkansas, through 
Tennessee, and the region of the 
Ohio river to Western Pennsylva- 
nia. 

Description. — A tree from forty 
to sixty feet high; bark, rough and 
broken across; leaves, from two to 
three feet long ; flowers, yellow ; seed 
pods, large and woody and contain- 
ing two or more stony seeds and a 
mass of pulp somewhat resembling 
vaseline. 

Poisonous Parts of the Plants. — 

An alkaloid, cytisine, contained in 

the leaves and the pulp of the fruit. 

Used with milk as a fly poison. 

Treatment. — Emetics, stimulants, strong coffee. Alternate hot and 

cold douches to the head and chest. 

WOOLLY LOCO WEED. 

Botanical Name. — Astragalus molhssimus. 

Common Names. — Loco weed ; crazy weed. 

Habitat. — The great plains, Western Texas, New Mexico, South 
Dakota, Wyoming; most abundant in Colorado, Western Nebraska, and 
Kansas. On pasture lands of the dry prairies and on rocky hillsides. 

Description. — Silvery-white ; silky-leaved ; eight to twelve inches high ; 
flowers, pea-shaped and purple. 




Fig. 112. Kentucky Coffee Tree 
(Gymnocladus dioica). One-third Nat- 
ural Size. 



POISONOUS PLANTS. 



627 



Poisonous Parts of the Plant. — An acid called loco acid in the whole 
plant. Horses, cattle, and sheep are affected by the plant. 

Symptoms. — There are two stages. First, which may endure for 
several months, is one of mania or hallucination; defective sight; after 




QC 




Fig. 113. Woolly Loco Weed (Astrag- Fig - "4- Stemless Loco Weed (Ara- 

ALUS MOLLISSIMUS), SHOWING THE WHOLE GALLUS LAMBERTIl) : (a) FLOWERING PLANT, 

Plant. One-third Natural Size. iP) Seed Pods; (c) Cross Section of Seed 

Pods. All One-third Natural Size. 

the animal acquires a taste for the food, it refuses all other kinds. The 
second stage is one of emaciation; sunken eyeballs; feeble movements, 
and the animal dies of starvation in from a few months to one or two 
years. 

Treatment. — Remove the animals from the neighborhood of the 
plants at once ; good food ; and the following tonic : — 

Powdered Sulphate of Iron, 1 ounce. 

Powdered Gentian Root, 4 ounces. 

Powdered Ammonium Chloride, 1 ounce. 

Powdered Potassium Nitrate, 1 ounce. 



628 



ACCIDENTS AND EMERGENCIES. 



Mix, and give a heaping teaspoonful, or a tablespoonful, according to 
the size of the animal, in the food three times a day. 

The stemless loco weed (Aragallus lambertii) is similar in appear- 
ance and effects to the woolly loco weed. 



RATTLEBOX. 

Botanical Name. — Crotalaria 
sagittalis. 

Common Names. — Rattleweed *, 
Wild pea. 

Habitat. — Low, sandy soils, 
from the Atlantic to Minnesota and 
Eastern Kansas; also in New 
Mexico. 

Description. — Three to eighteen 
inches high; leaves, simple and 
from one to two inches long; flow- 
ers, pea-like and yellow, appearing 
in July ; seed pods, an inch long and 
nearly black when mature; the 
walls of the pods are hard and when 
the seeds are detached give forth a 
rattling sound. 

Poisonous Part of the Plant. — 
Found in leaves and seeds. Gener- 
ally affects horses and cattle, and is 
supposed to be the cause of the "bot- 
tom disease." 

Symptoms. — Loss of strength 
and flesh, much the same as caused 
by the loco weed, which is a closely 
related plant. 
Treatment. — Give the animals a nutritious diet ; daily doses of : — 

Epsom Salts, 2 ounces. 

Sulphate of Iron, 2 drams. 

Nux Vomica, 1 dram. 

SPURGES. 

Botanical Names. — There are two varieties : Euphorbia lathyris and 
Euphorbia marginata. 




Fig. 115. Rattlebox (Crotalaria 
Sagittalis): (a) Whole Plant; (b) Cross 
Section of Pod. Both One-third Nat- 
ural Size. 



POISOXOUS PLANTS. 



629 



Common Names. — The former is known as garden spurge; myrtle 
spurge; mole plant; mole weed; mole tree; gopher plant; anti-gopher 
plant; wild caper; caper bush; wolf's milk; spring wort. The latter is 
also called snow-on-the-mountain. 





Fig. 116. (a) Caper Spurge (Euphorbia 
lathyris). One-third Natural Size. 
[b) Seed Capsule, Natural Size. 



Fig. 117. Snow-on-the-Mo untain 
(Euphorbia marginata). One-third 

Natural Size. 



Habitat. — Caper spurge is a common garden plant. Snow r -on-the- 
mountain is a native of the great plains from Montana to Mexico and 
is spreading rapidly eastward to Louisiana, Southern Minnesota, Mis- 
souri, Wisconsin, Illinois, and Indiana. 

Description. — Caper spurge is from two to three feet high; leaves, 
opposite and four-ranked; flowers, greenish-yellow and small; fruit, 
conspicuous and three-seeded. 

Snow-on-the-mountain is from two to four feet high; leaves, largely 
margined with white; a much more pleasing plant to the eye. 

Poisonous Parts of the Plant. — The milky juice of the caper spurge 
is highly purgative and poisonous. 



630 ACCIDENTS AND EMERGENCIES. 

Snow-on-the-mountain poisons chiefly by the honey which is made 
from its flowers. 

Symptoms. — Caper spurge juice, when applied to the skin, causes red- 
ness, itching, pimples, and sometimes gangrene. The effects last more 
than a week. The seed when eaten inflames the mouth and stomach and, 
in sufficient quantities, produces death. 




Fig. 118. Poison Ivy (Rhus radicans). Fig. 119. Poison Oak (Rhus diversi- 

One-fourth Natural Size. loba). One-third Natural Size. 

The honey made from the flowers of snow-on-the-mountain is hot and 

of a disagreeable taste. It produces vomiting and purging, but its effects 

are not serious. The juice of this plant acts upon the skin with an 

effect similar to that of caper spurge, but so severe is it that ranchmen 

n the West use it in place of hot iron for branding cattle. 

Treatment. — Emetics, and give at once milk, white of tgg in water, 
or flaxseed tea; inhale dilute ammonia; excessive purging is corrected 
by opium ; ipecac and veratrum viride have proven of great benefit when 




POISON SUMAC 
(Rhus vernix). 



POISON IVY 
(Rhus radicans), 



POISON OAK (Rhus diversilohaV 



POISONOUS PLANTS. 



631 



seeds were eaten. When the skin is poisoned, wash with a solution of 
lead acetate (sugar of lead) in alcohol. 



POISON IVY. 

Botanical Name. — Rhus radicans. 

Common Names. — Poison oak ; poison vine ; three-leaved ivy ; poison 
creeper ; mercury ; markry ; black mercury ; markweed ; pickry. 

Habitat. — Everywhere in open brush, in ravines, edges of woods, 
roadsides and fields, abundantly throughout the United States except in 
California. 

Description. — Climbing or trailing 
plant; leaves, of three leaflets (the 
Virginia creeper has five). Aerial 
'rootlets; flowers, greenish, appearing 
in May or June; fruit, smooth and 
waxy, often seen on the plant late in 
winter. 

POISON OAK. 

Botanical Name. — Rhus diversilo- 
ba. 

Common Names. — Poison ivy; ye- 
ara ; California poison sumac. 

Habitat. — Cool western mountain 
slopes and ravines, especially on the 
Pacific coast from Lower California 
and Arizona to British Columbia. 

Description. — Differs from poison 
ivy especially in the shape of the leaf- 
lets. They are thicker, smaller, less 
sharply lobed, and more nearly ellip- 
tical. 




Fig. 120. Poison Sumac (Rhus 
vernix). One-fourth Natural 
Size. 



POISON SUMAC. 

Botanical Name — Rhus vernix. 

Common Names. — Swamp sumac; 
dogwood; poison elder; poison wood; poison swamp sumac; thunder- 
wood. 

Habitat. — Swamps and woods from Florida to Canada and west to 
Louisiana. 



632 



ACCIDENTS AND EMERGENCIES. 



Description. — A shrub from six to thirty feet high; long leaves, of 
from seven to thirteen leaflets; wood has a slight odor of sulphur, and 
stems and branches are marked by leaf scars. 

Poisonous Parts of the Plants. — All of these produce the same poison- 
ous effects. The poison is due to an oil, called toxicodendrol, which 

occurs in all parts of the plants. Poison 
ivy is the poisonous plant of America. 

Symptoms. — The oil when it touches 
the skin, even in very minute quantities, 
irritates and poisons it. There are itch- 
ing; swelling; pimples containing a 
watery secretion; thirst; vomiting; colic; 
fever and delirium. 

Treatment. — Apply the following lo- 
tion : — ■ 

Grindelia Robusta, 1 ounce. 

Water, from 10 to 48 ounces. 

Wash the parts frequently. The very 
best possible application is a solution of 
lead acetate (sugar of lead) in alcohol. 

Frequent washing with soapsuds and 
hot water is good. This treatment applies 
to all of these poisonous varieties. 

LILY OF THE VALLEY. 

Botanical Name. — Convallaria majalis 




Fig. 121. Lily of the Valley. 
One-third Natural Size. 



Common Names. — May lily; May 
blossom. 

Habitat. — A native of Europe and of the United States. It is seen 
most frequently in cultivation in gardens. In the wild state it is found 
in the higher mountains in Virginia, North Carolina, and Tennessee. 

Description. — A low-growing plant with two broad, green, conspicu- 
ous leaves marked with distinct veins. The flowers are sweet-scented, 
pretty, bell-shaped, and white. They are borne on a central scape and 
usually hang to one side. The several parts of the plant are smooth. 

Poisonous Parts of the Plant. — All parts of the plant, including the 
flower, contain a highly poisonous material which chemists call con- 
vallamarin. This has a bitter, and, later, a sweetish taste. The leaves 



POISONOUS PLANTS. 



633 



of the plant have a bitter and acrid taste which prevents their being 
eaten by children. A few cases of poisoning by the several parts of the 
plant have been recorded. 

Symptoms of Poisoning. — Nausea and vomiting; diarrhoea; slow 
heart action, followed by irregular action of the heart; finally, death 
from paralysis of the 
heart. 

Treatment. — Place 
the patient in a horizon- 
tal position, which must 
be maintained for some 
time after the symp- 
toms subside. Give an 
emetic, if vomiting has 
not already occurred ; 
mustard, a tablespoon- 
ful to a small cup of 
water repeated in fifteen minutes. Then 
give plenty of lukewarm water to facili- 
tate vomiting. Give plenty of good strong 
tea, or, if tannic acid is at hand, give thirty 
grains in a cup of water and then another 
emetic in ten minutes. Then give from 
one to two tablespoonfuls of Epsom salts 
in a teacupful of water, followed by plenty 
of water. Give stimulants of from two to 
four teaspoonfuls of brandy or whisky in 

water every one-half to two hours. Keep 

J . L Fig. 122. Corn Cockle. 

the body warm, and keep up the circula- {a) flowers and Seed Vessels 
tion by friction. in Sprays of Plant One-thirdNat- 

ural Size; (&) Seed of Natural Size; 
(b'.) Seed Magnified four times 
CORN COCKLE. Natural Size. 




Botanical Name. — Agrostemma githago L. 

Common Names. — Cockle ; rose campion ; bastard nigelle ; old maid's 
pink (in New Hampshire) ; mullein pink (in New Brunswick and Nova 
Scotia) ; licheta (in Vermont) ; and crown of the field. 

Habitat. — A weed in Europe ; introduced into the United States with 
grain seed imported; found in grain fields westward from Maine to 
North Dakota; southward in Eastern Kansas, Louisiana, and Florida; 



634 ACCIDENTS AND EMERGENCIES. 

rarely found in Wyoming and California; very rare in the dry region 
eastward from California to Texas and Eastern Kansas. 

Description. — From one to three feet high; flowers, violet-red and 
showy; leaves, long and narrow or grass-like' in shape; leaves, stem, 
and parts of plant whitish and woolly; stem, erect, not trailing; seeds, 
black, rough, and rather round. The illustration is one-third of the 
natural size. 

Poisonous Parts of the Plant. — All parts of the plant, but especially 
the kernel of the seed. The poisonous substance is a white powder, called 
saponin, because when shaken up with water it froths like soap. When 
inhaled, the powder causes sneezing. It has a sharp burning taste, but 
has no odor. 

Causes of Poisoning. — The seeds of the plants growing in wheat 
fields become mixed with the grain, and while there is machinery em- 
ployed in the process of flour-making especially designed to remove 
these, the process is a very difficult one. In flours of the lower grades, 
intended by the manufacturers for the feeding of stock, seeds of the corn 
cockle are often found. These cause poisoning in many of the recorded 
cases. Poultry running in the fields often eat the seeds and become 
poisoned. Where the quantity of the poisonous matter in flour is large, 
the poisoning is acute; where it is small and the flour is regularly eaten, 
the poisoning is chronic and gives rise to a disease known as "githagism," 
from the botanical name of the species of the plant, githago. 

All black specks in flour should be regarded with careful suspicion, 
for, while it may not be due to the presence of the ground seeds of this 
plant, it is at least a sufficient evidence that the process of manufacture 
is not of the most careful kind, or that the flour is of an inferior 
grade. 

Symptoms of Poisoning. — Intense irritation of the mouth, throat, 
stomach, and intestines, vomiting, headache, nausea, dizziness, diarrhoea, 
hot skin, severe pains in the spine; difficulty in walking and moving, 
and difficult and shallow breathing. In severe cases, coma or insensibility 
followed by death is present. 

Treatment. — The antidote is digitalis, itself a dangerous poison and 
to be administered only with medical supervision. 

Preventive Measures. — The rejection of flour containing black parti- 
cles of the roughened coat of the seed covering, and the planting of 
seed wheat in which there are no seeds of the corn cockle. All methods 
of eradication of the growing plants should be systematically adopted. 



POISONOUS PLANTS. 



635 



RED BUCKEYE. 

Botanical Name. — JEsculus pavia. 

Common Names. — Small buckeye; buckeye; horse-chestnut. 

Habitat. — Fertile valleys from Virginia to Florida, the Gulf States 
to Louisiana, in Arkansas, Missouri, Tennessee, Kentucky, Vest Vir- 
ginia, and cultivated in Pennsylvania. 

Description. — From eight to twelve feet high; leaves, opposite and 
long-stemmed ; flowers, numerous, bright red, appearing in March ; fruit, 
smooth; seeds, mahogany-colored and highly polished. 





Fig. 123. Red Buckeye (/Esculus 
pavia), (a) Flowering Branch; {b) 
Seed. Both Two-ninths Natural 
Size. 



Fig. 124. 

maculata). 



Water Hemlock (Cicuta 
One-half Natural Size. 



Poisonous Parts of the Plant. — The young shoots and the seeds con- 
tain a poison almost identical with that of the corn cockle. These parts 
are bruised and stirred into the water of small ponds and brooks to 
stupefy fish, which are then caught in the hands. Their flesh is not at 
all tainted by the poison when eaten. The treatment is the same as in 
corn cockle. 



6 3 6 



ACCIDENTS AND EMERGENCIES. 



WATER HEMLOCK. 



Botanical Name. — Cicuta maculata. 

Common Names. — American water hemlock; wild hemlock; spotted 
hemlock; spotted parsley; snakeweed; beaver poison; musquash root; 
muskrat weed; cowbane; spotted cowbane ; children's bane; death of 
man. 

Habitat. — Swamps and damp soil in the Atlantic States, and west 
to Louisiana, Iowa, Minnesota, Nebraska, Rocky Mountains, and New 
Mexico. 

Description. — From three to eight feet high; stem, hollow; branches, 
numerous ; leaves, finely dissected ; flowers', white ; roots, a cluster, spin- 
dle-shaped, from one and one-half to three inches long. 

Poisonous Parts of the Plants. — 
An aromatic, oily fluid, strongest in 
the root, but also occurring in the 
rest of the plant. This is one of the 
most poisonous plants in America. 

Symptoms. — Vomiting ; colicky 
pains; staggering; unconsciousness; 
frightful convulsions, ending in 
death. 

Treatment. — Emetics ; p u r g a- 
tives or enemas ; chloroform, chloral, 
and other means of meeting condi- 
tions as they arise. There is no 
known chemical antidote for the poi- 
son. 

OREGON WATER HEMLOCK. 

Botanical Name. — Cicuta va- 
gans. 

Common Names. — Water hem- 
lock ; cicuta. 

Habitat. — Wet or marshy places 

from British Columbia and Idaho 

south to northeastern California 

and the southern Sierra Nevada. 

Description. — From three to six feet high; stem, erect or straggling; 

leaves, compound, growing direct from the ground; flowers, white and 




Fig. 125. Oregon Water Hemlock 
(Cicuta vagans). 



POISONOUS PLANTS. 



637 



appearing in July and August ; root, fleshy and made up in two distinct 
parts. 

Poisonous Parts of the Plants. — An oily liquid, most abundantly 
found in the root, but occurring in other parts of the plant. 

Symptoms and Treatment are similar to those of water hemlock. 
The commonest cases of poisoning are among cattle. A piece of the 
root of the size of a marble is regarded as a fatal dose for a man. 





Fig. 126. Poison Hemlock 
(Conium maculatum). One-third 
Natural Size. 



Fig. 127. Great Laurel (Rho- 
dodendron maximum). One- 
third Natural Size. 



POISON HEMLOCK. 



Botanical Name. — Conium maculatum. 

Common Xames. — Hemlock; wild hemlock; spotted parsley; stink- 
weed; herb bennet; poison root; poison snakeweed; cashes; wode- 
whistle. 

Habitat.— Common on waysides and waste places in New York. 



6 3 8 



ACCIDENTS AND EMERGENCIES. 



West Virginia, Pennsylvania, New Jersey, Ohio, the New England 
States, Michigan, Wisconsin, Illinois, Louisiana, and California. 

Description. — From two to seven feet high; leaves, like those of 
parsley; flowers, small, white, in showy clusters, appearing in July and 
August ; fresh leaves have a nauseating taste and, when freshly bruised, 
have a disagreeable mouse-like odor. 

Poisonous Parts of the Plants. — A volatile alkaloid, known as conine, 





Fig. 128. Narrow-Leaf Laurel 
(Kalmia angustifolia). One-third 
Natural Size. 



Fig. 129. 
ris mariana), 
Size. 



Staggerbush (Pie- 
One-third Natural 



found in the seeds and leaves. The root is harmless in March, April, and 
May, but is dangerous afterwards. 

Symptoms. — Loss of muscular power; loss of sight; mind remains 
clear until death ensues from lung paralysis. There are no convulsions, 
as in water hemlock poisoning. 

Treatment. — Emetics; tannin (strong tea or oak bark infusion); 

stimulants; hot water bottles at feet; artificial respiration; hypodermics 

of atropine. 

BROAD-LEAF LAUREL. 

Botanical Name. — Kalmia latifolia. 

Common Names. — Laurel ; ivy ; mountain laurel ; sheep laurel ; poison 




MOUNTAIN LAUREL OR CALICO-BUSH (Kalmia latifolia) 



POISONOUS PLANTS. 



639 



laurel ; wood laurel ; small laurel ; rose laurel ; high laurel ; round-leaf 
laurel; American laurel; poison ivy; ivy bush; mountain ivy; ivy wood; 
big ivy; big-leaved ivy; calico bush; spoon wood; spoon hunt; kalmia; 
and wicky. 

Habitat. — On rocky hillsides ; in cattle ranges ; on mountain slopes, 
from Connecticut to Eastern Ohio ; along the Alleghanies to Georgia and 
Alabama as far as Louisiana and Alabama. 

Description. — From four to eight and, sometimes, from thirty to 
forty feet high; leaves, thick, flat, and shining; flowers, pink, inodorous, 
in showy clusters, appearing in May and June. 

Poisonous Parts of the Plant. — 
Andromedotoxin occurs in all parts 
of the plant except the wood. It is 
more poisonous than strychnine; 
sheep and cattle eat the plant and 
hundreds die from poisoning every 
year. 

Symptoms. — Nausea ; rather un- 
successful attempts to vomit; froth- 
ing at the mouth ; grating of the 
teeth; irregular breathing; dizzi- 
ness; drowsiness; coma and death. 

Treatment. — Animals are treat- 
ed with doses of oil, melted lard, or 
fat of bacon. This is successful if 
given early in the case. In cases of 
human poisoning, a one per cent al- 
kaline solution of permanganate of 
potash is a chemical antidote. Other 
poisonous species of this family are 
the narrow-leaf laurel (Kalmia 
angustifolia) ; the great laurel 
(Rhododendron maximum) ; the 
staggerbush (Picris mariana) ; and the branch ivy (Leucothoe catesbaei). 




Fig. 130. Branch Ivy (Leucothoe 

CATESB.^l). 



FALSE JESSAMINE. 

Botanical Name. — Gelsemium scmpervirens. 

Common Names. — Yellow jessamine; yellow jessamine of the South; 
wild jessamine; Carolina jasmine; woodbine; Carolina wild woodbine; 
evening trumpet flower. 



640 



ACCIDENTS AND EMERGENCIES. 



Habitat. — Climbing over shrubbery and trees in woods and on low 
grounds from Eastern Virginia and Southern Tennessee to the gulf and 
into Mexico. 

Description. — A woody vine, thirty or more feet in length; leaves, 
small and evergreen; flowers, large, fragrant, yellow, one to one and 
one-half inches long, appearing in March and April. 

Poisonous Part of the Plant. — A poisonous alkaloid, gelsemine, is 





Fig. 131. False Jessamine (Gel- 
semium sempervirens). one -third 
Natural Size. 



Fig. 132. Jimson Weed (Datura 
stramonium). one-third natural 
Size. 



found in the bark of the root. The root is used in medicine, and many 
cases of poisoning result from overdoses. 

Symptoms. — Nausea; ineffective attempts to vomit; pain in the eye- 
balls and the brows ; loss of sight ; weakness ; staggering ; suffocation ; and 
death from lung paralysis. 

Treatment. — A strong current of electricity; conine and atropine; 
the stomach pump ; strong coffee ; whisky ; and artificial respiration. 

JIMSON WEED. 

Botanical Name. — Datura stramonium. 

Common Names. — Jamestown weed; common stramonium; thorn 



POISONOUS PLANTS. 641 

apple; apple of Peru; devil's apple; mad apple; stinkwort; stinkweed; 
Jamestown lily; the white man's plant. 

Habitat. — Waste ground about dwellings everywhere east of Iowa 
and Louisiana; also in Kansas, Nebraska, and Colorado. 

Description. — From two to five feet high ; leaves, large ; stem, coarse 
and green; flowers, white, two to four inches long, and heavily scented, 
appearing from May to September; seeds, numerous and as large as a 
grain of buckwheat. 

JIMSON WEED. 

Botanical Name. — Datura tatula. 

Common Names. — Jamestown weed; purple thorn apple; common 
stramonium; thorn apple; mad apple; stinkroot; stinkweed. 

Habitat. — More abundant towards the South and West than the last 
named. 

Description. — Taller than the last named, and bears purplish flowers. 

Poisonous Parts of the Plant. — The poisonous alkaloids, atropine and 
hybscyamine, are found in the Jimson weeds. The seeds are especially 
poisonous. Adults are poisoned by excessive use of the alkaloids as a 
medicine or stimulant. Children eat the seeds with serious and often 
fatal effects. 

Symptoms. — Headache; vertigo; nausea; extreme thirst; skin, dry 
and burning ; dilated pupils ; loss of sight ; mania ; convulsions, and death. 

Treatment. — Emetics or stomach pump; strong tea; tannin; oak 
bark infusion; and stimulants. Pilocarpine and licorice are both useful 
in cases of dry mouth and throat. 

BLACK NIGHTSHADE. 

Botanical Name. — Solanum nigrum. 

Common Names. — Common nightshade; nightshade; deadly night- 
shade; garden nightshade. 

Habitat. — Rich, shaded grounds and fields in all parts of the United 
States east of South Dakota and Arkansas, and in wet and damp places 
west to the Pacific Ocean. 

Description. — One to two feet high; stem, rough and angular; leaves, 
egg-shaped, and two to four inches long; flowers, small, white, and in 
clusters; berries, black, juicy, ripening from July to September or Octo- 
ber. 

Poisonous Parts of the Plants. — An alkaloid-like compound, solanine, 
in all parts, even the berry. 



642 



ACCIDENTS AND EMERGENCIES. 



Symptoms. — Stupefaction; staggering; loss of consciousness, feel- 
ing, and the power of speech ; cramp ; convulsions ; pupil, dilated ; death 
in a small per cent of cases follows from lung paralysis. 

Treatment. — Emetics; cathartics; stimulants, such as whisky, wine, 
or strong coffee. A solution of ordinary washing soda is recommended. 





Fig. T33. Black Nightshade (Sola- 
num nigrum). One-third Natural 
Size. 



Fig. 134. Bittersweet (Solanum 
dulcamara). One-third Natural 
Size. 



BITTERSWEET. 

Botanical Name. — Solanum dulcamara. 

Common Names.— Woody nightshade; bittersweet nightshade; wolf 
grape ; violet bloom ; scarlet berry ; nightshade vine ; garden nightshade ; 
staff vine; fever twig; tetonwort. 

Habitat. — Brooks and ditches from Massachusetts to Ohio, and in 
damp ground from Maine to North Carolina, and westward to Wisconsin 
and Missouri. 



POISONOUS PLANTS. 643 

Description. — From three to six or eight feet high; climbing; leaves, 
thin, the lowermost of which are heart-shaped and the upper more spear- 
shaped ; flowers, purple; fruit, red, ripening from July to October or 
November. 

Poisonous Parts of the Plants. — In addition to solanine, there is also 
dulcamarine, which gives the plant a bittersweet taste, whence its name. 
The plant is mildly poisonous, and the symptoms and treatment are the 
same as in the foregoing plant. 

SPREADING NIGHTSHADE. 

Botanical Xame. — Solanuni triflorum. 

Common Xame. — Wild potato. 

Habitat. — A native of the Western plains, abundant among the 
"prairie dog villages," and a garden weed from Arizona and Texas to 
British Columbia. 

Description. — A low plant, with angular stem; leaves, with from 
seven to nine lobes; flowers, small, white, in clusters in groups of three; 
berries, large and green, more than half an inch in diameter. 

Poisonous Part of the Plant. — The berries are poisonous, and, while 
not attractive to the eye, are agreeable to the taste. The poisonous prin- 
ciple is solanine. 

Treatment. — -Similar to that for black nightshade. 

SNEEZEWEED. 

Botanical Xame. — Helenium autumnale. 

Common Xames. — Sneezewort; autumn sneezewort; autumn sneeze- 
weed ; staggerweed ; swamp sunflower ; false sunflower ; ox eye ; yellow 
star. 

Habitat. — In moist ground from Connecticut to Michigan and Illinois 
and southward to the gulf; less abundant from Louisiana to Oregon 
and Washington ; also in Arizona. 

Description. — From one to three feet high; leaves, rather thick, and 
lance-shaped; flowers, showy and yellow, appearing in autumn. 

Poisonous Part of the Plant. — The poison is chiefly in the flowers. 
The powdered plant, when snuffed, causes sneezing. 

Symptoms. — Rapid pulse; difficult breathing; staggering: and great 
sensitiveness to the touch. 

Treatment. — No fatal cases of poisoning from sneezeweed among 
human adults are recorded. When cattle are affected, doses of melted 
lard are of value. 



644 



ACCIDENTS AND EMERGENCIES. 
BLOODROOT. 



Botanical Name. — Sangiunaria canadensis. 

Common Name. — Bloodroot; red puccoon; red root. 

Habitat. — Low grounds around rocks; in meadows. 

Description. — Flowers, white, slightly tinged with pink and blue; 
leaves, round and slightly cut ; root, a tuber about the size of one's finger ; 
when cut, a reddish orange juice is discharged. 





Fig. 135. Spreading Nightshade (Sola- 
num triflorum). one-third natural slze. 



Fig. 136. Sneezeweed ( Helen ium 
autumnale). One-third Natural Size. 



Symptoms. — Greatly increased flow of saliva; violent vomiting; severe 
purging; fainting; dizziness; cold feet and hands; pupils, dilated; tem- 
perature, low; pulse, slow; very marked prostration; thirst, intense; 
convulsions ; collapse ; and death from heart and lung paralysis. 

Treatment. — Stomach pump or emetic, such as mustard (a table- 
spoonful in a small cupful of water, repeated in fifteen minutes if not 




BLOODROOT (Sangninaria canadensis). 



POISONOUS PLANTS. 645 

effective) or syrup of ipecac, a teaspoonful every ten or fifteen minutes, 
until vomiting is produced. Follow the emetic with plenty of lukewarm 
water. Stimulate with brandy or whisky (two teaspoonfuls in a table- 
spoonful of hot water every ten or fifteen minutes), or aromatic spirits 
of ammonia (a teaspoonful in a little water every ten or fifteen minutes), 
or by strong coffee 

INDIAN TOBACCO. 

Botanical Name. — Lobelia inflata. 

Common Names. — Emetic herb; wild tobacco; puke weed; asthma 
weed. 

Habitat. — Dry, open places all over the United States. 

Description. — From one to two feet high ; flowers, small, blue, grow- 
ing out of a capsule, and appearing from June to October. 

Poisonous Parts of the Plant. — The leaves, seeds, and inflated cap- 
sules are poisonous. "A dram of the powdered leaves is considered a 
fatal dose." — Brundage. 

Symptoms. — Vomiting, depression, and prostration; purging; cold 
perspiration; pale, clammy skin; pulse, feeble; dizziness; convulsions; 
coma ; collapse ; and death in from one-half to four days. 

Treatment. — Place the patient on his back in bed and let him main- 
tain this position after the worst symptoms have disappeared. Stomach 
pump or emetic, followed by two tablespoonfuls of castor oil. Stimulate 
with brandy or whisky in small, frequent doses, or with aromatic spirits 
of ammonia. Use hot water bottles, or hot bricks, applied to the feet 
and sides of the body. 



BOOK VIII. 

INJURIOUS HABITS AND THEIR EFFECTS 



ALCOHOLISM 



is a diseased condition produced by the continued introduction of alcohol 
into the body. Notice several things about this definition. First, it is 
a diseased condition, therefore drunkenness does not develop into 
alcoholism until some diseased condition has been set up, and this 
usually requires frequent potations. 

Proprietary Medicines. — Notice, also, that nothing is said about 
liquors. That is because a great deal of alcohol is consumed quite 
outside of liquors, especially in the form of proprietary medicines; 
usually called "patent medicines," although most of them are not patented. 
The damage done by these liquors pretending to be medicines is frightful. 
Thousands of men and women who could not be induced to enter a 
saloon, drink these "patent medicines" regularly in private until they 
becomed confirmed alcoholics. They contain all the way from twenty 
per cent to forty-four per cent of alcohol, while bond whisky is fifty 
per cent alcohol, and beer less than five per cent. The rest of the 
"medicine" is water, colored by less than one per cent of some drugs 
to salve the conscience (?) of. those who advertise and sell the stuff, at 
a dollar per bottle, as a sure cure for every curable and incurable disorder 
from "blues" to cancer and consumption. 

The First Steps in this road to ruin are often taken quite innocently. 
It is often by the advice of a friend, or even of an unscrupulous physi- 
cian, that the first bottles are taken ; thus a craving for more is started, 
and this soon becomes a consuming fire which is never quenched. And s 
incredible as it seems, there have been innocent consumers of "patent 
medicines" in an advanced stage of alcoholism who did not know what 
was the matter with them, and who were properly astonished and horri- 
fied at learning that they were just plain, common drunkards. So the 
drug store catches those who escape the saloon. 

The spread of this has become so alarming that at last the Commis- 
sioner of Internal Revenue has ruled that all so-called medicines which 
contain as much alcohol as liquors do, must be listed and taxed as liquors. 
One of the most notorious of these hypocritical drunkard-makers is 



ALCOHOLISM. 647 

no longer allowed to be sold as a medicine in the state of North Caro- 
lina. 

As a result of long agitation, patent medicine advertisements are 
now refused by an increasing number of the most respectable periodicals. 
Some of these have made still greater sacrifices by refusing all objection- 
able advertising matter, such as promotes liquors, wild-cat mining, oil, or 
rubber stocks, extravagant claims of any kind, or those offensive to good 
taste. What moral heroism that involves, only those can understand 
who have had actual experience in the struggle to make a magazine 

pay- 
But it matters not in what way the alcoholic thirst is first awakened, 
the frightful results are the same, and they are too familiar to need 
describing. The amount of money worse than wasted on intoxicants 
is appalling. The total which the people of the United States paid for 
alcoholic drinks in 1903 was one and one-fourth billions of dollars. To 
this should be added $100,000,000.00 as a conservative estimate of the 
retail cost of the flood of proprietary "medicines" which they swallowed, 
since these are practically alcoholic drinks and strong at that. 

Who Pays the Drink Bill? — Strange to say, most of this burden 
of expense and disease falls upon those who are least able to afford it — 
the poor. The rich man's champagne cuts a very small figure in the na- 
tion's drink bill ; that frightful total of waste was piled up by the millions 
of nickels which crossed the bar instead of buying food, fuel, and clothing 
for the poor workingman's wife and children. Visit any building in 
process of construction and note the scores of empty bottles strewn every- 
where. They tell the story. How shall men be saved from themselves ! 
Of course, there is no excuse for all this folly. The exercise of 
a little self-control and self-denial would put an end to most of it. A 
great deal has been printed lately about alcohol as a food, and some 
profess to find justification in the experiments of Professor W. O. 
Atwater for their habitual use of it. It is not worth while to discuss 
the extremely doubtful value of alcohol as a food. We all know what it 
is as a drink, at least from observation, and that should be enough for 
any person of sense to leave it alone. 

To the Third and Fourth Generation. — If the evils of alcoholism 
were restricted to the drunkard, he might claim that it was nobody's 
business what he drank. But the sins of the fathers shall be visited 
upon the children, even unto the third and fourth generation. Physi- 
cians know how true that is. There are certain diseases which are inter- 
changeable — alcoholism, insanity and idiocy, epilepsy, syphilis, and tuber- 



648 INJURIOUS HABITS. 

culosis — which means that the presence of any one of them in the parent 
is almost sure to manifest itself in the child by one or the other of these 
frightful disorders. And it is a striking scientific confirmation of the 
Biblical statement, that modern medicine has discovered that it takes 
at least three generations for one of these diseases to run itself out, even 
under the most favorable conditions. 

Marry a Drinking Man? — Therefore the woman who marries a 
drinking man runs a frightful risk. If the risk were all her own, we 
might excuse, although we could not applaud; but the worst risk is her 
children's. And if the husband goes from bad to worse until he develops 
alcoholism, the wife is guilty of the most atrocious crime which is possible 
if she continues to bear children whose very lifesprings are poisoned. 

The Nursery of Crime. — Alcoholism is bad enough in and of itself, 
but it does not stop there; it is the instigator and abettor of every 
crime on the docket. Murder, robbery, arson, licentiousness, and political 
crimes of every description find fitting inspiration, a congenial hatching 
place, and a safe retreat in the saloon. It is unnecessary to dilate on 
this plague spot which spreads everywhere like a social leprosy; every 
one is familiar with the details already. 

Many Heroic Efforts have been made to combat this monstrous 
menace of everything which is good in the world, and the battle is still 
on. Although success is still far from sure, the nature of the struggle 
has changed decidedly within a century. It is no longer the correct thing 
for "gentlemen" to drink themselves under the table, nor for "ladies" to 
ply their callers with intoxicants. In good society, there has been 
developed a decided improvement in the outward observance, at least, of 
decency, the tendency being now more in the direction of coquetting with 
dangerous drugs. Also there has been developed a large preference for 
beer and other liquids containing a small percentage of alcohol. 

The Good Old Times. — When we compare this with the "good old 
times" when every man drank rum as a matter of course, even the 
immortal Washington and New England clergymen; when gentry could 
get crazy drunk and sally forth into the streets to smash windows, insult 
women, and fight with the "watch," and yet not forfeit high consideration 
in society, it is apparent, even to a pessimist, that "the world do move." 

The Dangers from Alcoholism To-day are different from those of 
one and two centuries ago. In general they are less open, coarse, and 
violent, and they need different treatment. Particularly is this true since 
the saloon "entered politics." There it is at the same time the most 
subtle and dangerous foe of good government, as well as of manhood 



ALCOHOLISM. 649 

and womanhood. Its tremendous power is due to the fact that it has 
shrewdly planted itself deep in the soil of human nature by catering to 
a universal social need. 

"The children of this world are in their generation wiser than the 
children of light." While reformers have been preaching against the 
saloon and holding up to drinkers the ideal beauty of teetotalism, the 
saloon has gone on quietly securing the support and friendship of the 
workingman by supplying to him that which he could not find in his 
miserable home or anywhere else — a bright, warm place for meeting 
his fellows socially, for learning of employment, for meeting his "boss," 
for raising a small loan, for loafing when out of work, and even for 
concocting crime. The saloon keeper is usually a power in local politics, 
with large opportunities to reward and punish. Opposed to all this con- 
crete advantage, pulpit and platform have nothing to offer the working- 
man more tempting than the pure joys of a clear conscience and the 
unsympathetic virtue of a reform government. Is it any wonder that 
the saloon seems invincible? 

The Three-Headed Monster. — So it comes about that the social 
problem of alcoholism is identified largely with the saloon problem, and 
that has its roots deep in "practical politics.'' The combination is tre- 
mendous, and it cannot be denied that the progress of reform is slow 
and uncertain. Evidently preaching does not fill the bill, not even of 
total abstinence. It might be better to take a leaf from the enemy's 
book of tactics. Is there any better way of drawing the workingman away 
from the saloon than to furnish him with something which will more 
than take its place? 

Remedies of various kinds are being tried with more or less success — 
social settlements, missions, parental clubs, people's places, and the 
like. All honor to the heroic men and women who are devoting their 
lives to those efforts to help their fellow men to help themselves. They do 
immense good, but so far they are few and feeble compared with the 
enormous evil which they are combating. The most encouraging sign 
of the times is that modern social reform, ever since the establishment 
of Toynbee Hall in London a quarter of a century ago, has come to be 
more and more practical and scientific. Clear-headed, earnest men and 
women, leaving theories behind them, have gone right into the slums 
to live, in order to study and attack the evil at short range. Preaching- 
has been made secondary to work. The salvation of our cities is hang- 
ing on their success. 



650 INJURIOUS HABITS. 

ALCOHOLISM AND ITS TREATMENT. 

Poisoning with alcohol is that condition of mind and body produced 
by excessive use of alcohol. What constitutes an excessive use of the 
drug varies with the individual. While the Pharmacopoeia of the United 
States lays down very carefully the doses of other poisons used in medi- 
cine, it is rather significant that no mention is made there of doses of 
alcohol, wines, or liquors. But it has been laid down on good medical 
authority that the system cannot digest more than two ounces of alcohol 
a day. This would be the amount contained in two glasses of liquor, 
four glasses of light wine, or five medium glasses of beer. If a greater 
amount than that is taken in any case, by even the most inured, the 
effects .as a poison are noted. In some cases one-half of these quantities 
in twenty-four hours will prove slightly poisonous. 

Causes.— The causes of the poisoning are, directly, the taking of the 
poison into the system. Behind this are the causes for a man taking 
alcohol in poisonous quantities. These are the influences of unfavorable 
moral, social, and personal conditions ; and heredity. Heredity may in 
a broad sense be made to stand for them all. It is not for a moment 
meant that anyone inherits from an ancestor a love of strong drink, or 
a desire to drink to excess. What a man does inherit is a lack of self- 
control; an enfeebled power of resistance; no moral courage to face the 
inevitable hardships of daily life; or a cowardice that permits him to 
seek a few hours of forgetfulness of uncomfortable conditions rather 
than to solve them by facing them. And this same inheritance shows 
itself in many other ways ; he is slipshod in his methods and habits ; he 
is one of "life's failures" for the very same reasons that he is a drunkard ; 
not because he is a drunkard. This condition of mental and moral 
degeneracy is very largely the reason why a man becomes addicted to 
liquor. The habit of taking the poison in so-called "moderate quanti- 
ties" for some time regularly, or of taking large quantities immoderately 
at times, produces physical changes and diseased conditions which cause 
a man to remain a drunkard. 

Effects of Alcohol. — In acute alcoholism there is a congestion of 
blood in the brain ; the stomach blood vessels are filled with blood (blood- 
shot) ; the interior of the stomach is lined with a quantity of mucus 
like rope; and the kidneys are also congested with blood. 

In chronic alcoholism, there is not an organ that is not in some way 
affected by the poison. There is chronic catarrhal inflammation of the 
stomach; the alcohol passes directly from the stomach to the liver and 



ALCOHOLISM. 651 

after congestion and other disturbances there is the condition known 
as gin drinker's liver; the kidneys are chronically congested with blood 
and become inactive; the interference with the circulation of the blood 
supply brings on chronic gastric catarrh ; the heart assumes the condition 
known as fatty degeneration of the heart; there is hardening of the 
brain tissues and inflammation. The lowered vital resistance renders 
the subject liable to attacks of pneumonia and tuberculosis. 

Symptoms of Acute Alcoholism. — These vary in degree and kind, 
according to the stage and sort of poisoning. In acute alcoholism, there 
are mild intoxication, drunkenness, acute delirium, and acute coma (insen- 
sibility). There is at first a feeling of exhilaration followed by a desire 
to carry out silly and foolish suggestions, caused by the action of the 
poison on the brain. When the action on the muscles begins, there is 
a lack of muscular control ; the patient staggers and, perhaps, falls ; if 
the amount of alcohol has been sufficient, the deep sleep or coma follows. 
This condition, technically known as dead drunk, is very often mistaken 
for the symptoms of other diseases which it resembles. Very often 
serious results follow a careless or hasty diagnosis of persons in this and 
similar conditions and of those suffering from fracture of the skull, apo- 
plexy, uraemia, congestion of the brain, or hemorrhage of the brain, all of 
which diseases have some points in common. But there is a very certain 
diagnosis of acute alcoholism by which it can be distinguished from all 
these affections. It consists in pressing with considerable force upon the 
two notches in the orbit of the eye, known as the supraorbital notches. 
These can be felt just below the middle of the eyebrow. If sufficient 
pressure is exerted upon them, the patient suffering from acute alcoholism 
will be restored to consciousness and his senses. Xo case should be 
finally diagnosed as alcoholism, even though the odor of alcohol be 
upon the breath, until this infallible test is applied. There are also 
stertorous (snoring) breathing; bloated and congested face; swollen 
and purplish lips; contracted or dilated pupils of the eyes; cold and 
clammy skin; slow and feeble pulse. 

In chronic alcoholism,- there are marked symptoms of dyspepsia, 
coated tongue, foul breath, distressing vomiting in the morning, muscular 
tremor, broken rest and sleep, puffing under the eyes and yellow and 
bloodshot eyes. The face is either very pale, bloated, and flabby, or 
is blotched, swollen, and rough. Headache, dizziness, and visions 
are almost always present. The mental faculties become impaired ; 
the memory fails; the judgment is bad; the moral sense and the will 
power are weak. The bowels are usually constipated and urine scanty, 



652 INJURIOUS HABITS. 

due to the changes in the stomach and kidneys. Great irritability of 
temper is a marked symptom of chronic cases. 

Delirium Tremens. — Delirium tremens, or mania a potu, is a disease 
of the brain, usually caused by an abuse of spirituous liquors, but some- 
times also by great mental anxiety and loss of sleep. Delirium some- 
times makes its appearance in consequence of a single debauch; but 
more frequently it is the result of protracted or long-continued intem- 
perance. It usually supervenes on a fit of intoxication ; but it not unf re- 
quently occurs, also, when the habitual drunkard omits his accustomed 
draught. 

Symptoms. — The approach of an attack is almost invariably pre- 
ceded by the patient being remarkably irritable, with fretfulness of 
mind and mobility of body. He becomes very nervous and uneasy; is 
startled by any sudden noise, the opening of a door or the entrance of a 
visitor ; is restless ; the hands and tongue are tremulous ; he complains 
of inability to sleep, and, if he dozes for a moment, he is awakened by 
frightful dreams. Soon delirium manifests itself; if questioned, the 
patient often answers rightly enough ; but if left to himself he begins to 
talk or mutter; he is surrounded by frightful or loathsome animals; is 
pursued by some one who has a design upon his life; has terrible and 
ghastly visions. Though most commonly of a frightful or terrifying 
character, the delirium is not always so; occasionally the appearances 
are droll and ludicrous, and the patient seems amused by them ; at other 
times it turns on some matter of business, as settling of accounts or 
telling of money, and the patient is in a perpetual bustle, and his hands 
are constantly full of business. The predominant emotion with a delirious 
patient is fear, and in his efforts to escape from an imaginary enemy 
he may be guilty of a murderous assault, or, as is more frequently the 
case, may take his own life; and hence he requires to be very carefully 
watched. The delirium continues until the patient sinks into a sleep, 
from which he awakes comparatively rational, or dies from exhaustion. 
In such cases, death is often sudden. The patient rises for some trivial 
purpose, and falls in a faint, from which he never recovers; or at length, 
after passing many nights without sleep, he sinks into a state of coma, 
which terminates in death. This disease, however, is rarely fatal, unless 
where the strength of the patient has been seriously impaired by long- 
continued excesses. 

Treatment. — The great remedy is sleep, and the best means of induc- 
ing this is by chloral, which is to be given in large doses, and frequently 
repeated, until the desired effect follows. Sometimes it is necessary, in 



ALCOHOLISM. 653 

order to procure sleep, if the patient is in a very exhausted state, or if the 
disease has been brought on by the cessation of an accustomed stimulus, 
to allow the patient a certain quantity of his ordinary beverage ; but this 
should not be continued longer than he can do without it. Chloroform 
has also been recommended as a means of procuring sleep when opium 
fails; or better probably than either will be found to be the hydrate of 
chloral in doses of from five to fifteen grains. Some medical men recom- 
mend large doses of digitalis, but the nature of this remedy renders it 
unadvisable in the hands of any but a medical man. 

If these efforts are successful and the nervous excitement is subdued, 
there will be great prostration of strength. The great object will then 
be to restore the tone of the siomach, and to enable the patient to over- 
come that craving for alcoholic stimulants which is sure to send him 
back into the paths of intemperance if it is indulged. Strychnia in doses 
of one-sixtieth of a grain three times a day combined with elixir of 
calisaya makes an excellent tonic for these cases. A cold shower bath 
affords great relief. 

This disease is to be carefully distinguished from inflammation of the 
brain, with which it has many symptoms in common; for bleeding, 
which is resorted to in the latter disease, would be of the utmost danger 
in this. 

Prognosis. — This is good in acute alcoholism provided the patient 
is manageable. 

But in chronic cases there is such complication of disease in serious 
forms, as well as from delirium tremens, that the danger is great. Heart 
failure and coma are always to be feared. Many cases of alcoholism 
are fatal by reason of succumbing to lobar pneumonia. 

Treatment. — Very many of the serious consequences of over-indul- 
gence of liquor might be averted or entirely prevented if regular meals 
of nourishing, easily digested food be taken during the period and if the 
bowels are kept open. Much of the harm results from going a long 
time without food in the stomach. For there is no nourishment in 
liquor. Hence the caution against taking liquor on an empty stomach. 
What the stomach most needs at these times is good care; and when 
the early morning drink is taken, it should be followed immediately by 
food of some sort, if only in the form of a glass of milk with a raw egg. 
Very often in the attempt to work up an appetite by the use of liquor in 
the morning, the object is defeated by taking too much and all desire 
for food is lost. 

If, during the drinking period before a stage of acute alcoholism is 



654 INJURIOUS HABITS. 

reached, the stomach is cleansed of the ropy mucus which accumulates in it 
and the liver is relieved of the alcohol which forces its way directly to it 
through the portals, the severity of the attack will be lessened and much 
time in the after-treatment will be gained. Such a dose as the following 
may be taken or given with advantage during the course of drinking : — 
Calomel, 1-3 grain. 

Take one such powder every hour for five hours and follow with 
Epsom salts, Hunyadi Janos water, or other saline aperient. At such 
times the administration of medicine is often difficult or well-nigh 
impossible; but a Seidlitz powder in the morning is often willingly 
taken, which affords some measure of help in this direction. Strong, 
black coffee in the morning is an excellent stimulant which can often 
be made to take the place of a morning stimulant. But it must be 
strong and hot and not in too large quantities at a time. Such a cup 
of coffee will produce about the same effect as from one to two grains 
of caffein. Aromatic spirits of ammonia in half-teaspoonful doses in 
water every two or three hours will serve as a stimulant in place of 
liquor. 

In acute alcoholism, where there is stupor or coma, the first step in 
treatment is the same as in other cases of poisoning, viz. : to administer 
an emetic to remove the alcohol from the stomach to prevent further 
effects from it. To eliminate the poison from the system, there is, per- 
haps, nothing so efficacious as : — 

Solution of Ammonium Acetate, 2 ounces. 

Take a tablespoonful in water every two hours. 

For nervousness, when very great, use : — 

Extract of Guarana, 5 grains. 

Bromide of Sodium, 30 grains. 

Take one such dose every four hours in water. 

Rest and sleep are the great things to be sought for to prevent 
hallucinations, ordinary delirium, or delirium tremens. Where these 
threaten, the physician will administer a hypodermic injection of morphia, 
or atropin, or hyoscin. 

Restlessness, insomnia, hallucinations, and mild delirium are also 
controlled by chloral hydrate in thirty-grain doses, or by trional in 
thirty-grain doses, but these are better not given and certainly not 
repeated without medical direction. 

Sleep and rest will follow the elimination of the poison and the 
supply of nourishing food. 



ALCOHOLISM. 655 

Patients have usually been without food for some days and the 
stomach is in bad condition. Where food can be tolerated, give milk 
and limewater, or milk and Seltzer. Hot broths, hot beef tea, well 
seasoned with cayenne pepper, should be given in small quantities every 
two hours. 

To increase the appetite and to tone the stomach use : — ■ 

Tincture of Nux Vomica, 4 drams. 

Tincture of Capsicum, 4 drams. 

Compound Tincture of Gentian, ... to make 4 ounces. 

Give a teaspoonful well diluted every two hours. 

If aromatic spirits of ammonia are given to stimulate the heart and 
nerves, the above may be given every four hours and the ammonia 
alternate with it. The ammonia may then be given in teaspoonful doses 
in hot milk. 

For. alcoholic nausea and vomiting use: — 

Nitrate of Strychnia, % -grain. 

Fowler's Solution of Arsenic, 20 drops. 

Glycerine, 3 drams. 

Take one teaspoonful every four hours. 

The withdrawal of alcoholic stimulants from patients suffering from 
poisoning by it, whether acute or chronic, is a matter of skill, judgment, 
and tact. There is no doubt that the disease will continue so long as the 
use is continued. But there is often a danger of withdrawing it too sud- 
denly in some cases. No cure of the disease can be permanent if it is 
continued. This is a mental and moral question with the patient. Where 
he is willing to help, much can be done in the way of a cure. Without 
this support and willingness on his part, there is little hope. Much 
suffering must be undergone by him during this time. There is need 
Qf discipline which home life and private treatment do not afford. 
Hospital or sanitarium treatment is of the greatest use; but, best of 
all, if a man can be taken away from associations and to places where 
liquor cannot be obtained, with the addition of outdoor life and good, 
healthy surroundings, combined with a companion who does not drink 
and who can exert some control and good influence over him, then 
there is good reason to expect a cure. 

But no matter what the sort of treatment, the patient will always do 
better if a large and wholesome sympathy is extended to him. On the 
development of symptoms of addiction to liquor or forming of the habit, 
a man's friends should get together and lend him all the support possible, 



656 INJURIOUS HABITS. 

not in an ostentatious, offensive, patronizing way, but steady, well-directed 
assistance and interest, with special efforts to supply him with those 
elements of self-control and self-respect of which he feels the need. There 
is no condition of mind or body that so much demands the fellowship 
and assistance of his friends ; and none that will respond so rapidly to 
tactful efforts. 

CIGARETTES. 

If a boy or girl is quite determined to accomplish self-destruction by 
a slow but sure route, there are several ways open. There is the 
alcohol route, or the cocaine, morphine, acetanilid, or arsenic route, or 
cigarette smoking. Any of these may be guaranteed to afford the 
young aspirant for perdition a maximum of physical suffering and dis- 
grace in this life, to say nothing of eternal punishment through enfeebling 
the will, blunting the moral sense, and the general lowering of the whole 
spiritual tone. 

"Coffin nails" is the name felicitously given to these little nuisances 
and neurotics. It is difficult to understand the hold which they have 
upon the popular fancy. One would suppose that the annoyance of 
being obliged to fold them so frequently, light up, puff a few times, and 
then have it all to do over again, would discourage the cigarette fiend. 
Those most addicted to cigarettes are usually least addicted to persistence 
and industry in any other direction, yet they seem to find a fatal fascina- 
tion in eternally rolling the little paper tubes. Perhaps it is that very 
fact, the simple monotonous repetition of the mechanical act, furnishing 
just enough occupation for their idle fingers and feeble minds. 

Most Smoking is altogether an acquired taste, finding its origin, 
not in any natural craving, but in the boyish aspiration "to be a man." 
Boy-like he overlooks the fact that many noble, strong men never smoke, 
and infers from the too prevalent example of his elders that he must learn 
to smoke if he is to be manly. Probably if it were not for this unfortu- 
nate example, there would be no cigarette smoking, for of itself it cannot 
be said to convey any positive pleasure. 

The Secret of its Power and of its mischief is in the hold which 
it soon secures upon the nervous system. Like every other drug, nicotine 
— the active poisonous principle of tobacco — has two effects, a primary 
and a secondary. For most people its first effect is sedative, but con- 
tinued use brings on great nervous irritability and general depression. 
Excessive use soon produces alarming symptoms : nausea, f aintness, 
vertigo, feeble digestion, failure of the eyesight, distress about the heart. 



CIGARETTES. 657 

convulsions, insanity. In short, it is a powerful depressant, especially 
of cardiac action, so that "tobacco heart" has come to be recognized as 
the cause of many sudden deaths. Of course mind and memory are im- 
paired and ambition destroyed. 

The Newspapers Frequently Record the disastrous effects of 
cigarette smoking. Anyone who doubts it has only to engage the services 
of a clipping bureau and he will be supplied with a surfeit of murders, 
assaults, thefts, insanity, and deaths due to cigarettes. Just for illus- 
tration : In 1905 a Cleveland boy of twenty-one years of age was put 
on trial for assaulting his mother. He was in the habit of smoking 
fifty cigarettes daily. A Louisville boy of fourteen went insane on a 
daily dose of one hundred coffin nails. Another, twenty-three years 
old, in London township, Michigan, accomplished a like result on one 
hundred twenty-five daily. A baseball pitcher died at Chillicothe, Ohio, 
from only twenty-five cigarettes a day, although he was twenty-nine 
years old. But the small number is explained by the fact that it had 
been his daily average for fifteen years. 

Generally speaking, the younger the smoker the worse the effects. 
Thus it required only thirty-five cigarettes a day to put a Chatsworth, 
Illinois, youth in the insane asylum. Whatever opinion may be held as 
to the effects of tobacco on adults, all agree that it is deadly poison during 
the formative period of the "teens." But even adults are not safe. There 
was a case reported in the newspapers, of a Chicago traveling salesman 
who had been addicted to cigarettes so long that his symptoms became 
alarming and he promised his wife to drop them. He did so, but his 
nervous system had become so dependent on the sedative that the sudden 
deprivation drove him temporarily insane. He went back to his slavery, 
feeling that he was a doomed man either way. 

No Cigarette Fiends Need Apply. — This vice has become so wide- 
spread and its effects so generally understood, that a very determined 
war is being waged upon it from all sides. The efforts of the anti- 
cigarette leagues are being ably seconded by employers of labor, including 
railroads, banks, manufactories, wholesale and retail firms. Many of 
them absolutely refuse to hire or retain cigarette smokers in their employ; 
one glance at the telltale finger stains is sufficient to secure a refusal 
or a dismissal. Railroads in particular say that they cannot afford to 
take any chances with boys and men having unreliable nerves or eye- 
sight. Even the grand jury for November, 1905, in its report on the 
penal institutions of Cook County, Illinois, recommended that cigarettes 
be abolished from the county jail. 



658 INJURIOUS HABITS. 

Birds of a Feather. — Like alcoholism, the cigarette vice must bear 
the odium of much related evil. The general lowering of the moral 
tone, the loss of true manliness and self-respect, lead inevitably to loaf- 
ing, profanity, obscenity, lying, stealing, and kindred crimes; while the 
extreme nervous irritability prepares the way for deeds of violence. 
This a priori proof is confirmed a posteriori by examining the fingers 
of convicted criminals when they are first brought to our penal institu- 
tions — nearly every examination will reveal the familiar yellow-brown 
stains. Superintendent George Torrance, Illinois State Reformatory, 
testifies that out of 278 boys in that institution, between the ages of ten 
and fifteen, 92 per cent had the cigarette habit when admitted. Of these, 
85 per cent were "cigarette fiends." That tells the story. 

Popular Fallacies. — There are several mistaken notions current in 
regard to this vice and its effects. For example, it is supposed that the 
danger of cigarettes lies in their being "doped," that is, treated with 
opium, cocaine, etc. That is out of the question for the simple reason 
that they are sold too cheaply to admit of introducing expensive drugs. 
Furthermore, a large number of smokers roll their own cigarettes. 
Another fallacy is that strong tobacco is the cause of the deadly results. 
Quite the contrary, the tobacco is usually mild. 

The Real Reason. — What, then, is the real reason? There are 
several. First of all, the early age at which the vice is usually started. 
In the teens, the nervous system is far more susceptible to toxic effects 
than later. Secondly, the vast number consumed daily by the "fiends." 
One hundred cigarettes a day are as injurious as ten full-sized cigars 
or twenty pipes of tobacco. Third, the habit of inhaling. This, by 
giving the full effect of the tobacco, affords the greatest satisfaction and 
inflicts the greatest damage. Inhalation of cigarette smoke is easier 
than that of cigars or pipes because the smoke is milder and less in 
quantity, but the habit thus formed is afterwards extended to all smok- 
ing with still more disastrous effects. 

Tobacco Smoke is Composed of several ingredients, of which the 
most poisonous are nicotine and carbon monoxide. The latter, mixed 
with hydrogen, forms the deadly "water gas." Nicotine is one of the 
swiftest and surest toxics known, and has been used by murderers for 
poisoning their victims. If either of these two were present in tobacco 
smoke in appreciable quantities, the smoker's shrift would be short 
indeed. But when the deadliest poisons are introduced in minute but 
frequent attenuations, the body has an adaptability which enables it to 
tolerate their presence, manifesting only the chronic symptoms. 



CIGARETTES. 659 

Guard the Children. — These facts need only to be presented without 
exaggeration to young people of sense to enlist them on the side of 
health, and morals, and decency. Those without sense must go their 
own way to their own place. "Against folly the gods themselves contend 
in vain." Teachers and boards of education find no difficulty in enrol- 
ling thousands of enthusiastic young anti-cigarette leaguers as soon as 
the matter is put before them in its proper light. The children are more 
sinned against than sinning. This cigarette plague has sprung up within 
a quarter century, sedulously spread by unscrupulous manufacturers 
and dealers by means of pictures, gaudily colored boxes, prize labels, 
and other devices for luring the thoughtless. At the same time the price 
has. been reduced to bring them within the reach of the poorest. Even 
girls have been drawn into the net in alarming numbers. But there 
these devil's own overshot their mark. Public opinion in the United 
States, careless and optimistic though it be, has not yet been educated 
down to the level of Europe and Asia, where the spectacle of women 
smoking in public excites no comment. Far distant be the day when pub- 
lic opinion shall be ready to tolerate the idea of American women defiling 
their pretty lips with either cigarettes, cigars, or pipes. The report that 
girls were learning to smoke cigarettes capped the climax and sealed 
the fate of the cigarette. To their credit be it said that many of the better 
class of girls have formed leagues of their own, ostracizing every boy 
known to smoke cigarettes. That is the way woman may exert her 
influence most powerfully for good. 

The strong tendency of tobacco to produce cancer when brought habit- 
ually in contact with an irritated tissue is well known ; especially through 
the pitiful deaths of President U. S. Grant and of Emperor Frederick III. 
of Germany. As these words are being penned, the newspapers contain 
accounts of operations on two actors, one in Xew York and the other 
in Chicago, to remove cancerous growths caused by excessive smoking. 
Each man was obliged to have his tongue cut out to save his life, and for 
one of them it was the fourth operation, successive portions of his tongue 
having been cut away. 

DRUG FRAUDS. 

There are two kinds, those in which there is too much drug and those 
in which there is too little. The second class has been described already 
under Alcoholism. It covers all the proprietary "medicines;" which 
usually contain less than one per cent of drugs and from twenty to forty- 



660 INJURIOUS HABITS. 

four per cent of alcohol, so that they are really powerful intoxicants and 
must be classed as such. 

The class which contains too much drug may be further subdivided 
into two species, those which conceal the drug ingredient and those which 
advertise it. In either case both the intent and the effect are evil. The 
first is a drug fraud ; the second is not only a fraud, but an open catering 
to one of the most deadly vices. 

Under the First Head is marshaled a long array of headache pow- 
ders, soothing syrups, asthma, catarrh, cough, consumption, and kidney 
"cures" ; excluding those which print a formula of the ingredients. They 
are all frauds in that they promise a cure, whereas they only relieve 
from pain. A relief is justifiable, provided it is not a dangerous relief, 
and provided the remedy is not worse than the disease. The public is not 
squeamish when it is in pain. What it wants is to be rid of the pain, 
and that quickly. Of this intolerance of suffering, the ready relief and 
quick pain killer take full advantage and reap riches, while the public 
exchanges its pain for chronic disease and often for speedy death. The 
sales are enormous and increasing in geometric ratio, fostered by every 
pleasing and lying device of skillful advertising. 

The Worst of These Devices is the free sample distribution. The 
unscrupulous dealers are not satisfied with what might be considered 
the legitimate business of relieving suffering, they reach out with greedy 
claws for the far greater profits which can be secured by starting a 
vicious craving and then pandering to it. They call it "supplying the 
public demand." They know very well that thousands of unthinking 
people, who are always glad to get something for nothing, will be sure 
to put a free sample drug into their mouths whether they need it or not. 
The craving is easily started and then they must have more. The fiend 
who sells the stuff rubs his hands gleefully as the customer who first 
came in once a month begins to come in once a week and then semi- 
weekly, until he is fully started on the downward career of the "dope 
fiend." He, or she, has now but one object in life, to secure greater 
and greater quantities of the deadly drug which drags down to hell ; 
for the sake of that indulgence, money, health, honor, friends, are reck- 
lessly sacrificed until death or the madhouse closes the tragedy of a 
Lost Soul. 

The Dangerous Ingredient of most, if not all, headache powders is 
acetanilid, a derivative of aniline, which is obtained from coal tar. It 
is a powerful depressant, especially of the heart ; collapse has been known 
to follow a dose of four grains, and death, a dose of five grains. It is 
four times as powerful as antipyrine. The newspapers have published 



DRUG FRAUDS. 601 

twenty-two deaths from acetanilid poisoning in two years. How many 
more cases of death from heart failure were due to the same drug, it is im- 
possible to say, but it is a significant and alarming fact that deaths from 
that cause are decidedly on the increase in the United States. These 
acetanilid powders are guaranteed on the wrappers to cure an absurd 
multitude of diseases, which fact alone should condemn them for intel- 
ligent people. Nor do they utter any warning of the dangerous character 
of their chief ingredient; on the contrary, one of the most popular of 
the headache powders, after claiming to cure nearly every known disease, 
caps the climax of mendacity by claiming to be a powerful tonic for 
physical and mental fatigue. Now, the real action of acetanilid is 
directly the opposite, being so powerful a depressant of the heart that 
sufferers from cardiac weakness take it at the risk of their lives. In 
July, 1905, a girl in Philadelphia, eighteen years old, took the dose of 
two powders, according to the printed directions. In three hours she 
was a corpse. 

Perhaps the Most Atrocious of these frauds — if it is possible to 
estimate degrees in such villainy — is the soothing syrup, since here the 
crime is committed against helpless babes, who have the greatest claim 
upon every one's pity and protection. The number of fortunes which 
have been acquired through this modern slaughter of the innocents is 
beyond computation ; every person of intelligence knows that their effect 
is due to morphine, codeine, or some similar drug; and still the infamy 
flourishes. If Herod is able to keep himself familiar with mundane 
affairs, he must grieve to think that he was born too soon to get into 
the soothing syrup business. 

Cocaine Frauds. — The drug frauds which carry the formula on the 
bottle are usually the asthma, catarrh, cough, and consumption "cures," 
containing cocaine. They are frauds because they promise a cure 
which they cannot effect; they are w T orse, because the publication of the 
formula is a cunning invitation to the "cocaine fiend" to buy the stuff. 
One popular cough "cure" contains four per cent of cocaine. Of the 
frightful effects of the cocaine habit it is hardly necessary to speak in 
detail. The person addicted to it has a pale, cold skin, often bluish; 
feeble pulse and labored breathing; anesthesia and illusions of the 
senses; thirst, dryness of throat, and malnutrition; headache, giddiness, 
and restlessness ; trembling of the limbs and muscular twitchings ; death 
usually from heart failure. Of course the mind is impaired and memory 
almost useless. The only thing for which the wretch cares to live is to 
get more cocaine. 



662 INJURIOUS HABITS. 

MORPHINE AND THE DRUG HABIT, AND ITS TREATMENT. 

Symptoms. — There is slowly developed a marked irritability of 
temper, so that the patient either flies into a rage or breaks into tears. 
Melancholy and delusions become so profound as to suggest insanity. 
The ordinary acts of life are performed with stealth and slyness. Habits 
of exaggeration, distortion, and prevarication are very pronounced. All 
of the person's ingenuity and skill are employed in subterfuge and 
deceit in order to procure the drug. The most characteristic and marked 
symptom is the contraction of the pupils of the eyes, even to the pin 
point size in some cases. The patient seldom looks another in the eye 
without a fluttering of the eyelids, either from nervousness or from 
an effort to hide the small size of the pupils. 

Perfect isolation and absolute control of the patient are absolutely 
necessary to work a cure. All treatment is useless and disappointing so 
long as there is any possibility of the patient procuring or of using 
the drug without the knowledge of the physician. 

Treatment. — There are in use two methods of treatment. The first 
consists in the gradual decrease of the dose so that at the end of a week 
all has been withdrawn. Of course something must be substituted for 
it to meet the fearful mental and physical suffering which this causes. 
Great care is needed that the medicine which replaces it does not lead 
to the contraction of a habit in that direction. It is a comparatively 
easy matter to substitute alcohol for morphine. Many patients do that 
for themselves. That is only exchanging a Roland for an Oliver. 

On the withdrawal of the drug, there will be great restlessness, 
irritability, depression, purging or diarrhoea, and extreme mental and 
physical suffering. Cramps in the legs, feet, arms, and hands are also 
noted. The great nervous depression is removed by doses of hyoscya- 
mus ; the circulation is kept up by strychnine and digitalis ; the purging 
is controlled by : — 

Aromatic Sulphuric Acid, 15 drops. 

Fluid Extract of Hsematoxylon, 1 dram. 

Chloral, sulphonal, or trional may be used to control the mental 
excitement and to procure sleep and rest. The cramps in the extremities 
are relieved by hot bandages; and a short, quick, hot bath will lessen 
the nervousness. The patient is supported during the first stage by 
hot stimulating food highly seasoned with cayenne pepper. 

The second method of treament consists in the immediate and com- 
plete withdrawal of the drug, with substitution of hyoscine administered 



INSANITY. 663 

in small hypodermic doses. In this treatment, the patient is either 
stupefied or put to sleep during the greater part of the period of ordinary 
suffering and so is helped over it. Then the hyoscine is withdrawn and 
the patient helped to recovery. 

From either of these methods there is great danger of lapses. That 
is true of all methods. Some doubt has been cast upon the permanency 
of any cure for the habit ; but that is a great exaggeration of the number 
of lapses. There are some of such weak will power and so deficient in 
moral and physical courage that the inability to face the ordinary hard- 
ships and difficulties of daily life drives them back to the old bondage. 
But, on the other hand, there are many cases of permanent cure known to 
every physician. There is no possibility of self-treatment and reduction 
outside of a hospital or sanitarium, where the necessary rigid control and 
discipline can be given. 

INSANITY. 

What is it ? Easy to ask, but hard to answer. For, in the first place, 
the question involves the deeper problem of the nature of the soul and 
its relation to the brain. The materialist, who regards spirit as merely 
highly refined and sensitive matter, has no such difficulty, for he needs 
only to define insanity as a disease of the brain tissues. 

But from the earliest times there has been a strong belief in the 
existence of a something called a Soul, quite distinct from matter, at the 
same time that it uses the brain and voluntary nervous system as its 
instruments. But the connection between the two is so intimate that any 
injury, disorder, or disease of the instrument immediately affects the 
user; and, if the injury is sufficiently severe, the two part company at 
once and forever. 

Another Difficulty in defining insanity arises from the almost infinite 
variety of its manifestations, and the vagueness of the dividing line 
between sanity and insanity. It has even been said that we are all more 
or less insane. Certain it is that many people considered sane are all 
the time doing crazy things, and sometimes it is almost impossible to 
say just when and where their absurd performances cross the boundary 
line. In fact, the moment suspicion or investigation is seriously directed 
against any person's mental condition, he or she will find that many 
words and acts which before had been charitably labeled "eccentricities" 
will suddenly take on significance as evidence of insanity. 

The Modern Scientific View of insanity is that it is strictly and 
wholly a disease of the brain, and it is to be treated accordingly. But 



664 INJURIOUS HABITS AND THEIR EFFECTS 

there is still a strong belief, especially among the laity, that it may also 
be a disease of the mind or soul, either wholly or in part. This belief 
has been strengthened by the commission of atrocious crimes by those 
who appeared to be mentally or morally unsound without manifesting 
any cerebral symptoms of disease. All this ground has been fought 
over repeatedly in courts, especially in the case of Guiteau, the mur- 
derer of President Garfield. 

The necessity for defeating the plea of insanity in defense of such 
miscreants has greatly strengthened the view that insanity is strictly 
a physical disorder. Nevertheless, the fact remains that constant brood- 
ing over wrongs or troubles, real or imaginary, will cause one to become 
possessed by fixed delusions. That is a matter of common observation, 
and also, every one who is skillful in introspection is conscious of such 
tendencies which must be resisted. Usually such delusions are compara- 
tively harmless, and the person is regarded merely as a "crank," but 
under exceptional conditions some delusions may become so extreme 
as to result in action which clearly passes the boundary line of sanity. 

Emotional Insanity is the name usually given to this, although 
many deny that there is any such thing. The difficulty of holding people 
accountable for the acts of emotional insanity is met by showing their 
responsibility for their mental and moral condition. Every one knows 
from his own experience that he can always choose between allowing 
himself to brood over troubles and turning his mind resolutely to other 
matters. If he is wise, he will not allow his mind to get into the habit 
of running constantly on one narrow subject, especially if it is painful 
or exasperating; even neutral subjects should be varied, and should be 
pursued with a mind always open to all the evidence and not previously 
committed to any theory or doctrine. It is by neglecting to exercise this 
power of choice that fanatics of all kinds distort their mental processes 
until they persuade themselves that they are justified in committing the 
most atrocious crimes in cold blood. For all crimes committed by those 
who thus pervert their own judgment, full punishment should be inflicted, 
for they cannot set up their voluntary self-perversion as an excuse in 
the absence of any brain disease. They have even less excuse than the 
man who commits murder under alcoholic excitement, and he is held 
responsible for his acts. 

The Duty of Every One, whether he 'takes the strictly materialistic 
view of insanity or not, is to avoid carefully everything which will affect 
the soundness of his mental and moral processes. The nervous system 
including the brain, is a highly sensitive and extremely complicated 



INSANITY. 665 

telegraph system, in which each nerve and ganglion is so closely related 
to every other that "an injury to one is the concern of all." Therefore 
no one should overtax or in any way abuse any part of his nervous sys- 
tem. 

At the same time, by cultivating a cheerful disposition, improving the 
mind, and avoiding brooding, we should secure a sane outlook upon both 
the great world and our own little corner of it. Particularly should those 
who are compelled to make a living by long, monotonous toil relax and 
refresh their minds by suitable reading, even if they can spare but a few 
moments daily. Those precious moments should not be wasted in read- 
ing yellow journal accounts of crimes and scandals, but in storing the 
mind with the best thoughts in literature, or with valuable facts which 
shall increase the worker's efficiency. Both kinds of reading will give 
him something to occupy his mind profitably during toil, to the exclusion 
of brooding or evil thoughts. Always have a little book in your pocket, 
to be pulled out at every suitable opportunity. How many thousands 
of precious hours are lost daily by men and women traveling to and fro 
from their work, gazing vacantly through the car windows — "golden 
hours lost, each set with sixty diamond seconds; no reward offered, for 
they are lost forever." 

Who is Insane? — Outside the legal question of punishment above 
noted, it makes little practical difference which theory of insanity is 
held — the only question is, Has the person lost intelligent control of 
himself ? 

The existence of brain disease, and even of delusion, hallucinations, 
and illusions, does not prove insanity in the sense that the person is irre- 
sponsible. For there have been many cases of people afflicted with various 
aberrations of the senses or of the mental faculties, of which they were 
perfectly well aware and which they did not allow to pervert their judg- 
ments or vitiate their actions. Such persons are not sane in the sense that 
"sane" means perfectly "sound," yet it would be most cruel and unjust 
to brand them with the stigma of insanity. In fact, if every one who 
is not perfectly sound mentally is to be adjudged, insane, "who then shall 
be saved?" It is absurd on the face of it, and yet there are some who 
uphold that theory. 

Kinds of Insanity. — Of course, violent mania is easily recognized; 
except when it is feigned for a purpose, as to escape the consequence of 
a crime. Even then the sham can always be exposed by a skillful physi- 
cian; for no one can simulate mania for any length of time successfully 
in the face of searching tests. It is more difficult to diagnose absolute!) 



666 INJURIOUS HABITS AND THEIR EFFECTS. 

the kinds of insanity which are near the border line and therefore 
resemble conditions of mind which are still responsible. Hysteria, melan- 
cholia, kleptomania, and inordinate egotism often hover between respon- 
sibility and irresponsibility. 

Still more difficult is it to diagnose a latent insanity, which comes to 
the surface only under special conditions. In such cases, the subjects 
appear perfectly rational, until some exciting cause produces an out- 
break. Often they are very cunning in concealing their condition, and 
succeed in baffling all investigation until some one subject is touched 
upon; then the special insanity suddenly manifests itself. 

The Test Question, therefore, must be, as already stated — has the 
person lost intelligent control of himself? Men and women eminent in 
the world's history, whose exceptional achievements prove them to have 
been as free from insanity as anyone, have been subject to illusions and 
hallucinations of the senses, sometimes consciously, sometimes uncon- 
sciously. They have seen "visions" and heard "voices" ; in some cases 
obeying, in others disregarding them. 

A common example of illusion is color blindness. The man who 
drives madly into an open draw is not necessarily insane ; he may be only 
unable to tell red from green. In many cases of accident or disease of 
the brain, certain faculties have been impaired or destroyed — such as 
speech, hearing, or motor power — without impairing the patient's ration- 
ality. Of course, they are not "sound" mentally, but they are not insane. 

The Causes of insanity are as numerous as the varieties of the dis- 
order. Most unfortunately, the increase of civilization multiplies the 
causes, and an effective remedy is hard to find. For, in spite of any 
amount of good advice, both professional and popular, and the general 
diffusion of intelligence, people will persist in continuing to do the very 
things which they know are likely to produce insanity. 

The causes may be either direct or contributory. Among direct 
causes are many diseases, especially those of a nervous type, as epilepsy, 
hysteria, meningitis, debauchery, alcoholism, excessive use of tobacco or 
drugs, long continued worry or mental strain, great grief, fright, and 
sometimes even joy. But contributory or predisposing causes generally 
precede the immediate and apparent cause. Everything which exag- 
gerates nerves at the expense of the muscles, drains the vitality or weak- 
ens mind and will power, prepares the way for the final shock which snaps 
the golden cord. 

The Rush for Wealth. — Of course, the mad rush for wealth, 
especially in our cities, and the equally desperate struggle of the poor to 



INSANITY. 667 

escape being submerged, predispose more and more to the loss of reason. 
While those who are wise refuse to allow themselves to be caught in 
this crazy whirl and carefully select the good of modern civilization while 
eschewing the evil, the unthinking majority rush recklessly on, aggra- 
vating the artificial and unwholesome conditions of urban life by utter 
disregard of hygiene and sanitation. Instead of seeking the change 
and refreshment of a quiet, suburban home, they crowd into filthy, noisy, 
treeless streets; hastily gulp down indigestible meals; keep late and 
irregular hours; and then spur their jaded nerves with strong coffee, 
tobacco, and liquors. When the outraged nerves take their revenge 
through insomnia, headaches, and neuralgias, the next resort is to all 
manner of drugs, and then the "dope fiend" is ripe for a grand final 
crash. In some moment of special strain, the few wits he or she has 
left, go glimmering. 

Rural Insanity. — But too little is almost as bad as too much. Out 
on the isolated farm or ranch, human life almost stagnates. The kill- 
ing monotony of seed time, harvest, and winter, with little human com- 
panionship and almost no social pleasures, no outlook upon the world, 
no ideals, no ambitions, can be realized only by those who have suffered it. 
Especially is this true of the farmer's wife, who is too often a mere slave ; 
broken down by work, sickness, and childbirth; with no joy of life and 
no hope of rest this side the grave. 

It is a pleasure to know that, although urban conditions increase 
insanity, rural life is becoming more and more favorable to mental 
soundness. Several agencies are contributing to this happy result, all 
having the common effect of bringing the farmer into closer touch with the 
great outside world, stimulating his mental faculties and breaking up his 
lifelong monotony. Rural free delivery brings him letters and papers 
daily ; the long distance telephone enables him to talk with anyone at any 
time, and to order goods, which the mail order house rushes out to him 
by the next train. The traveling library brings to his door the latest 
literature, while the suburban trolley is pushing farther and farther into 
regions which the railroad does not reach. 

Meanwhile the threescore agricultural stations established and main- 
tained by the United States Government are teaching the farmer how to 
farm, how to know soils and fertilizers and rotation of crops, how to 
put brains into his work. An army of agents and drummers besiege him 
to buy the best labor-saving machinery and the latest improvements of 
all kinds. The large central school, with 'bus conveyance for distant 
pupils, is supplanting the "little red schoolhouse" with its meager edu- 
cational facilities. 



668 INJURIOUS HABITS AND THEIR EFFECTS. 

The Solution of a Great Problem. — And in so many ways the rural 
population, which is a little more than half of the total population, is 
waking up. This fact will not only diminish the tendency to rural 
insanity, but — best of all — will furnish a solution to the most perplexing 
problem of our civilization — the rush of the young men and women from 
the farm to the city. Whatever makes life on the farm more endurable will 
relieve the congestion of the cities, and that will help to diminish urban 
insanity also. 

This beneficial result is already beginning to manifest itself, for the 
last United States census shows that the cities are not increasing as 
rapidly as they were. 

The Treatment of the Insane has been one of the dark blots on the 
page of history. In the earliest times, these unfortunates have either been 
regarded as inspired and listened to with superstitious reverence, or 
they have been judged to be possessed by devils and have been driven 
into the wilderness to perish. After civilization had progressed far 
enough to recognize some measure of moral responsibility for the unfor- 
tunate, a pretense for caring for the insane was exhibited, but with so 
much attendant neglect and brutality that being driven into the wilder- 
ness was scarcely a worse fate. 

Matters improved very slowly, and it is only in recent years that any 
really humane and intelligent care has been accorded the irresponsible. 
Even now there is much left to be desired. In the best asylums and 
hospitals, the treatment aims to surround the inmates with cheerful and 
healthful environment and the least possible restraint. 

The number of insane is increasing in most civilized countries. For 
the United States, the statistics of the twelfth census on this subject 
are not yet available; but in the decade from 1880 to 1890 there was an 
absolute increase (in round numbers) from 92,000 to 106,500 insane, 
Relatively to the increase of population in the same period, there was a 
slight decrease of insane. The number in 1896 is estimated at 145,000. 

Safeguards of the Insane. — Of course in a matter of such delicacy 
and complexity as the detection and care of insanity, there is infinite 
opportunity for blundering and downright rascality. The best of laws 
cannot altogether prevent that ; nothing can do it but an alert and intelli- 
gent public opinion, which insists on electing the best men to public office, 
and then holds them to a strict accounting for the judicious exercise of 
their authority. All asylums, both public and private, should be kept 
under strict supervision. 

Almost equally difficult is it to safeguard the commitment of the insane 



INSANITY. 669 

whether to public or private asylums. It is popularly believed that many 
really sane people have been railroaded into confinement by designing 
persons, and in the case of eccentric persons, especially, it would not be 
very difficult. So avoid being "cranky," particularly if you have enemies 
or wealth. 

Safeguards of the Sane. — But if we should try to make it any more 
difficult to commit the insane, we should fall into the opposite evil of not 
protecting the sane. For it happens too often that friends and relatives 
feel such repugnance to the stigma of insanity, that they try to care for 
the unfortunate in private long after he should be in an asylum, or he is 
allowed to be at large simply because it is nobody's business. Not until 
his insanity has broken forth in some terrible crime is he at last placed 
where he belongs. Such cases are reported almost daily, sometimes the 
butchery of whole families by insane persons. A higher sense of respon- 
sibility to the public welfare would lead those who are nearest to such 
cases to take action before the crime was committed, instead of after- 
ward. 

Responsibility of Experts. — A great deal of public condemnation 
has been visited upon experts, physicians, judges, and juries because they 
either have or have not declared people insane. Doubtless there have 
been cases where responsible people have escaped punishment through the 
plea of insanity, while other have been improperly committed to asylums. 

At the same time, we should not be hasty in condemning experts, un- 
less there is strong evidence of their insincerity or incapacity. For they 
stand in a trying position. The brief description above given is sufficient 
to show how difficult may be the problem of drawing the line infallibly 
between sanity and insanity, between responsibility and irresponsibility. 
Mere evidence of irrational words or acts is not conclusive, for few 
people always act rationally. Neither is evidence of cerebral disease or 
injuries conclusive, for they do not necessarily destroy self-control. 

That brings in the great question of self-control, which is more 
psychological than physiological. At what point does it cease? So long 
as self-control can be maintained, the responsibility of the patient con- 
tinues. People who commit crime often claim that they "could not 
help it," they were "driven by an irresistible impulse," and so on. Such 
statements should be given little credence, for their motive is obvious. 
It is significant that these same people who "could not help it," could 
exercise sufficient self-control to w r ait for a favorable opportunity for 
committing the crime without danger to themselves, could even plan it a 
long time ahead. In other words, they had plenty of self-control so long 
as it suited them to exercise it. 



670 INJURIOUS HABITS AND THEIR EFFECTS. 

Judge and Jury. — Worse still is the responsibility of the men who 
must pass final judgment in view of the law and the evidence. On the 
one hand is the humane desire to save a human being from close con- 
finement or the gallows; on the other, is the stern duty to protect the 
community from one who is actually irresponsible, or who is merely pre- 
tending irresponsibility in order to shield himself from just punishment 
or restraint. That would be difficult enough even if the case were pre- 
sented fairly and squarely on its merits; but, of course, that is never 
done; every cunning trick is employed to deceive both experts and jury 
as to the defendant's real condition. The final decision involves a fearful 
responsibility, requiring judgment and conscience of the highest order. 

SUICIDE. 

Self-murder is terribly on the increase in all parts of the world from 
which we have statistical reports. That this should be true of Europe 
is not so strange, where the common people are taxed to support vast 
armies and a large privileged class of aristocracy and officials, and are 
required to waste several of the best years of each man's life in military 
service. That is the regular thing, frequently diversified by a bloody 
war or massacre, or by a famine from failure of crops or employment. 
The condition of the common people in parts of Russia, Ireland, and 
England is beyond anything ever seen in the United States for abject 
misery and destitution, and the wonder is that, in spite of it all, they still 
cling to life. Suicide is most common in Dresden, Paris, Berlin, Genoa, 
Lyons, Vienna, Stockholm, Christiania, and London. In the first two 
the proportion of suicides to population is twice as great as in New York 
or Chicago. 

But in this great, free, prosperous land, it seems as if there were no 
occasion for suicide. Yet self-destruction in the United States is increas- 
ing rapidly, especially in the cities. In the fifty leading cities there was 
an increase of thirty-one per cent in population in the ten years ending 
with 1902, while the number of suicides in those cities increased from 
1,465 to 2,452, or more than seventy per cent. 

The Causes of this frightful increase are, of course, numerous. They 
include all the vice, folly, and crime of which poor, weak human nature 
is capable. Foremost stands alcoholism, with all its attendant train of 
miseries. The weak will, which in the first place gave way to the tempta- 
tion of the sparkling glass, being still further weakened by long continued 
indulgence, falls before the feeblest breath of adversity, disappointment, 
or even weariness of life. Other causes are despondency, business fail- 



SUICIDE. 671 

tire, ill health, grief, domestic trouble, love quarrels, disgrace, and 
insanity. 

Although Never Justifiable, some cases of suicide are far 
more inexcusable than others. Thousands take their own lives for 
alleged reasons which brand them at once as contemptibly lacking in 
moral and mental stamina. As examples may be cited the case of the 
young man of twenty-five who shot himself at home just before the 
family were to sit down to Thanksgiving dinner for the "reason" that 
he had been out of work three weeks ! How many men have been out 
of work months or years, and still fight bravely on ! A man over eighty 
killed himself because he was so well off that he was afraid he should not 
have any work to do! A schoolgirl killed herself because her mother 
scolded her ! A youth of nineteen shot himself because a sixteen-year-old 
girl would not promise to marry him and because he feared he could not 
get rich quick enough! A Missouri farmer leaped into the ciread un- 
known because of worry over having more money than he could invest ! 
Such idiocy seems incredible, yet its frequency proves how much suicide 
is utterly inexcusable and comtemptible. 

These Are Fair Samples of the weak and morbid people who con- 
tribute a large part of the statistics. Maudlin self-pity and impatience 
of a little disappointment; an overweening egotism which must have 
everything its own way and right away; utter poverty of mental re- 
sources, moral principle, or sturdy self-reliance; a selfish disregard of 
others' rights, all explain the number of weaklings who desert the battle 
of life. Such renegades deserve no sympathy, for their desertion is with- 
out excuse. The real reason, which they fail to give, is that for years 
they have been indulging themselves in weak and silly brooding, instead 
of doing their best to discharge their duty and rise superior to the ills 
of life. 

The Moral is Evident — don't brood; don't allow yourself to grow 
morbid ; don't be silly. Almost every one has had periods of depression, 
commonly called the "blues," in which he felt strongly impelled to pity 
himself, and imagine how the notice of his death would read in the 
newspapers, and how many people would say: "Poor fellow! We shall 
miss him sadly." And, if you are in love, you may be moved to maudlin 
tears at the mental picture of Her inconsolable grief when she perceives 
that she has trifled with your affections just a little too long, and now it 
is forever too late! 

Don't You Believe It. — Most of the few people who would pay any 
attention to a notice of your suicide would say: "What a fool! He 



672 INJURIOUS HABITS AND THEIR EFFECTS. 

could not have 'blown his brains out/ for he never had any." As to Her 
wasting any grief over you — well, you will do best to stay in ghostland 
and not try to come back to observe her devotion to your memory. 

The Best Cure for that kind of foolishness is to get outdoors and 
take a lot of exercise. Probably what ails you is eating too much, or 
biliousness. If possible, do some real hard work, preferably for the 
benefit of some one who needs help; otherwise, walk and run several 
miles. When you get home again, you will be surprised how the cobwebs 
have been swept out of your brain. 

Ennui. — Closely associated with maudlin self-pity, is simple weari- 
ness of living. This may come from having too much or too little; 
usually it is the latter. It is the unhappy portion of those who have 
neglected to improve their minds by study and good reading, and to 
enrich their souls with high ideals and ambitions. An animal may live 
very contentedly for any number of years on the satisfaction of the senses 
only, but an immortal soul must have something higher. Inevitably 
there comes a day when costly food and drink, jewelry, fine raiment, 
display and excitement, all the pride and pomp of fashion are naught 
but vanity and vexation of spirit. The jaded senses refuse to respond to 
the strongest or most cunning incitements. 

Then life becomes an awful blank. The victim of ennui is ready to 
do anything to get away from self, even to try to hide from self in the 
grave. Poor fool! Yourself is the one dreadful thing you must take 
always with you through all eternity! If you could have said with 
Sir Walter Raleigh, "My mind to me a kingdom is," you would have had 
a sure refuge from all the weariness of life. 

The Ancients. — In all this there is nothing especially new. In all 
the centuries, human pride and folly have always run the same course. 
It is recorded that Zeno, founder of the Stoics, hung himself because he 
fell down and put his finger out of joint. Empedocles is said to have 
jumped into Mount Etna, in order that it might be supposed that he 
had been translated miraculously to the gods. Sardanapalus, king of 
Assyria, being weary of life, resolved to make a grand exit in the most 
spectacular manner and with plenty of company. Having invited his 
favorites to a sumptuous banquet in a magnificent palace, he had it all 
set on fire in the midst of the carousing, so that he and all his guests 
went up in flame and smoke. 

Of a Different Kind are the suicides which are caused by poverty, 
long sickness, distress, disgrace, desperation, or domestic troubles. Al- 
though not justifiable they are not contemptible. They indicate a defr 



SUICIDE. 673 

ciency of moral stamina. They result from a false view of life, its duties 
and responsibilities. It is a pleasant philosophy that we are here to 
have a good time, that "the world owes us a living," but it is a false 
and dangerous philosophy. The cold truth is that the world owes us 
nothing. The sooner we recognize and accept that fact, the better will 
it be for our peace of mind and health of body. 

Neither are we here for a good time. On the contrary, we are in 
the primary and grammar grades of an educational course of which the 
high school and university are to be entered through the door of death. 
We are here to learn as fast as possible the great lessons of life — 
goodness, generosity, courage, patience, industry, and all the rest of it; 
these can never be learned by having a good time. They must be learned 
by bearing pain and trouble bravely and patiently, by rising superior 
to petty emergencies, by forgetting our own woes in comforting others, 
by a dogged determination to "win out" some day or other in spite of 
every discouraging obstacle. That spirit will never fly to suicide for 
relief. 

The Punishment. — The self-destroyer is therefore a shirk. He or 
she seeks to escape learning the lessons of life, like the child who plays 
truant because he does not like to study in school. Just what their 
punishment will be in the next life, it is impossible to guess, but there 
can be no doubt that there will be some punishment to fit the offense of 
those who presume to thrust themselves into the next higher grade before 
they have proved themselves fit. 

The Statistics of Suicide reveal some remarkable facts. Referring 
again to the statistics of the fifty cities, it is found that in those ten years 
more than three times as many males as females committed suicide. That 
is not very creditable to the courage and endurance of the men. Remem- 
ber that no one is ever a failure until he quits trying. 

More persons living alone than married killed themselves. It is not 
good that man — or woman — should be alone. Strange to say, most 
deserted the battle between the ages of thirty and forty, when strength 
and wisdom should be greatest; and the next greater number between 
twenty and thirty, when courage and ambition should be highest. Really 
old men, over seventy, kill themselves least of all. 



BOOK IX. 

SPECIAL SYSTEMS OF TREATING DISEASE 



HOMEOPATHY. 



Homeopathy is the name given to a system of medicine in 1806 by 
its founder, Samuel Hahnemann. After graduating in medicine from 
the University of Erlangen, Dr. Hahnemann settled in Leipsic, and 
afterward had direction of a large hospital in Dresden. 

In 1790 he was struck by the significant similarity of the effects of 
quinine and some other drugs on the healthy body, to the disease symp- 
toms for which they were commonly prescribed. Believing that he had hit 
upon a new and valuable principle in medicine, he pursued the subject 
zealously, and found such confirmation of his theory that he announced it 
to the world in T796. 

His Great Work, 'The Organon of Rational Medicine," came out 
in 1 8 10, and has ever since been the guide and authority of his followers. 
In 1835 he settled in Paris, where he enjoyed great reputation, until his 
death in 1843, During that period the French capital naturally became 
the Mecca of Homeopathists from all over the world. 

The new treatment spread rapidly in spite of much opposition and 
some persecution. Naturally the old-school physicians were opposed to 
the innovation, and they had the active sympathy of the apothecaries, 
since Hahnemann insisted on the single remedy and the minutest dose 
possible. While he was at Leipsic the apothecaries' company got an act 
passed forbidding physicians to dispense their own medicines, and in con- 
sequence Hahnemann was obliged to leave. The conflict between the two 
systems — called Homeopathic and Allopathic by the followers of Hahne- 
mann — was exceedingly bitter for a long time, many names were called, 
and harsh things said on both sides ; but now they have agreed to disagree 
in peace, and often work in harmony. 

Homeopathy in the United States has been especially prosperous. 
Its first college was established at Allentown, Pa., in 1835; and in the 
same year the American Journal of Homeopathy was started. Nine 
years later was organized the American Institute of Homeopathy, the 
oldest national medical association in the country. There are now in the 
United States about 15,000 Homeopathic physicians, and eighteen medi- 



HOMEOPATHY. 675 

cal colleges in which their therapeutics are taught. Many of these 
include in their courses of study all departments of medicine and 
surgery, with excellent clinical and hospital equipment. 

Homeopathy is a Large Subject, and only the essential features 
can be noticed in this place. As given in the Organon, they are — 
Proving of drugs upon the healthy; Prescription according to the law 
of similars; Single Remedy; and Minimum Dose. 

Although Hahnemann himself insisted upon all four, his followers 
have varied in regard to the third and fourth principles; many main- 
taining that the essentials of Homeopathy are comprised in the first and 
second. The law of similars — which Hahnemann expressed concisely 
as Similia similibus curantur — means that a disease can be cured by that 
medicine which, when given to a healthy person, will produce symptoms 
most similar to those of the disease. 

Provings. — The administration of medicines to healthy persons, in 
order to record the symptoms produced, is called "proving," and the 
symptoms are called "provings." Hahnemann and his immediate dis- 
ciples proved ninety drugs in this way, and the work has been carried 
out enthusiastically since then, so that now the Homeopathic materia 
medica contains over 400 proved remedies. About half of these are in 
constant use. 

That Fact Alone is sufficient to prove that no physician can be a 
competent Homeopathist who is not, like the founder, a profound 
student and a keen observer. The popularity and novelty of the system 
caused many to adopt the name who were merely shallow imitators, 
and lacked both industry and capacity for mastering the system. Until 
recently the laxity of government supervision of the practice of medicines 
made it possible for almost anyone to hang out a sign as a "Homeopathic 
Physician and Surgeon," and thus great discredit has been brought upon 
the name. But, in spite of this, the devoted and successful service to 
the sick, which has been rendered now for a century by thousands of 
capable Homeopathic practitioners, has overcome popular prejudice and 
professional opposition and has raised this school of medicine to a high 
rank. Last of all, it has received official recognition, and now it is 
allowed to share in the medical treatment and administration of many 
public institutions. 

The Number of Homeopathic general and special hospitals in the 
United States is ninety-six; sanitariums, sixty-one; other institutions, 
fifty-nine; dispensaries, fifty-six. The number of general and special 
hospitals where both schools of practice are represented is forty-two; 



676 



SPECIAL SYSTEMS. 



other institutions, nine. Number of Homeopathic national societies, 
nine; state societies, thirty-five; local societies, ninety-eight. Homeo- 
pathic journals, twenty-four. 

The Greatest Good — Of all the good things which Homeopathy 
has accomplished, probably the greatest is the reduction of the medicinal 
dose. In this gain all schools have had a share. No physician of any 
school now would think for a moment of prescribing the enormous doses 
and severe treatments which were customary in the time of Hahnemann. 
Part of this improvement must be credited, no doubt, to the general 
progress of intelligence among both profession and laity ; but the greater 
part is due to the continual object-lesson of Homeopathic precept and 
practice for the last hundred years. 



HOMEOPATHIC TREATMENT OF DISEASE. 



Abscess. — First stage, before pus has 
formed, give Belladonna, 3 x, and Mercurius 
Viv., 6 x, in alternation. When pus begins 
to form, give Hepar Sulphuris, 3 x. 

Sulphur, cc, is useful to remove a tend- 
ency to abscesses. Poultice and open freely 
as soon as suppuration takes place. After 
opening, wash out the abscess with Tinct. of 
Calendula, one part to ten of water. 

Abscess, of the Ear. — It is so liable to 
extend to the brain that a surgeon should be 
called early. The same remedies as above. 

Acute Inflammation of the Bowels 
(Enteritis). — Aconite, 1 x, quick, wiry pulse; 
dry, hot skin, and very restless. Arsenicum, 
3 x, burning pain in bowels ; tongue red and 
dry ; yellow, frequent stools ; vomiting ; very 
weak and debilitated. 

Colocynth, 2 x, violent, griping pain in the 
bowels. 

Veratrum Alb., 1 x, cold sweat; cramps in 
legs, with vomiting and diarrhoea. 

Keep hot packs of alcohol and water over 
the bowels and call a physician. 

Avoid all animal food. 

Anaemia. — Ars., 3 x, green sickness, when 
the result of a perverted nervous action. 

China, 3 x, resulting from excessive loss 
of blood or any debilitating discharges. 

Ferrum, 1 x, deficiency of red blood glob- 
ules. A change of climate, scene, air, etc., 
is often very beneficial. 

Apoplexy. — Give Aconite, 3 x, and send 
for medical assistance. Principal remedies 
are Aconite, 3 x, Belladonna, 3 x, Opium, 30, 
Arnica, 3 x, and Glonoine, 30. 

Aconite, 3 x, hard wiry pulse ; persons of 
full habit. 

Bell., 3 x, congestion of the brain ; red, 
swollen face ; throbbing of blood vessels ; 
dilated pupils, convulsive movements of the 
face and limbs, serviceable early in the case. 



Opium, 30, profound stupor; dusky coun- 
tenance ; contraction of pupils ; convulsed ; 
moans and groans ; cannot be aroused. 

Arnica, 3 x, after active excitement has 
subsided, to promote resorption of effusion. 

Nux Vomica, 3 x, is a useful remedy to 
prevent a predisposition to apoplexy. The 
diet should be plain, avoiding rich food and 
stimulants. Exclude all excitement, over-ex- 
ertion, sudden changes of temperature, and 
excesses of all kinds. 

Asiatic Cholera. — Camphor </> , great de- 
pression ; collapse ; chilly most of the time ; 
violent vomiting and purging ; give early in 
the disease. 

Arsenicum, 3 x, excoriating discharges; 
bright red tongue, with burning of stomach 
and bowels ; patient wild and restless ; useful 
in all stages of the disease. 

Veratrum Alb., 1 x, cold sweat; violent 
vomiting and purging ; cramps of different 
muscles of the body. 

Cuprum Aceticum. 30. also for cramps 
with empty retching : also to be used as a 
prophylactic. 

The diet should be milk with a little 
brandy added. 

Asthma. — Arsenicum, 3 x, Euphorbia 
Pilulifora, 1 x, Ipecac, 1 x, Veratrum Viride, 
1 x. 

Arsenicum, 3 x, hay-fever, watery excori- 
ating discharges from the eyes and nose. 

Euphorbia PH., 1 x, suffocative cough ; 
considered a spe<- : fic by many. 

Ipecac, 1 x, nausea and vomiting, followed 
by violent fits of coughing. 

Veratrum Vir., 1 x, hard, difficult breath- 
ing ; tight, wheezing cough ; full, hard, 
bounding pulse. 

Back, Lameness (Lumbago )l — Rhus Tor., 
3 x, for painful condition of the muscles 
from a sprain or wrench. 



HOMEOPATHY. 



6 77 



For crick of the back, Ferrum Phos- 
phoricum, 3 x. 

Baldness. — To prevent the hair from 
falling after fevers, etc., Fluoric Acid, 6 x, 
and Silicea, 30. 

Barber's Itch. — Sulphur Iodide, 3 x, 
every six hours, and apply Blue Ointment. 

Bilious or Remittent Fever. — Gelsemi- 
num, 1 x, the leading remedy for remittent 
fever ; pain in the head on the left side. 

Bryonia, pain on the right side of the head, 
extending to its base ; yellow coated tongue ; 
sallow complexion ; constipation or alternate 
constipation and diarrhoea. 

Merc. Protoide, 3 x, jaundice during the 
fever. 

Phosphorus, 3 x, may be given if there is 
a cough at the same time of the jaundice. n 

Bleeding from the Nose (Epistaxis). — 
Aconite, 1 x, for plethoric persons, with 
hard, quick, wiry pulse. 

Carbo Veg., 3 x, severe nosebleed, several 
times daily, with pale face before and after 
each attack. 

Nitric Acid, 3 x, disposition to nosebleed. 

Bleeding from the Lungs (Hemoptysis). 
— Hamamelis, <f>, ten drops, every hour, for 
dark blood which is profuse or scant. 

Veratrum Vir., 1 x, congestion of the 
lungs, with full, hard, bounding pulse. 

Phosphorus, 30, disposition to frequent 
hemorrhages with dry, hacking cough. 

Bronchitis. — Aconite, 1 x, at commence- 
ment, with hot, dry skin and quick pulse. 

Bryonia, 3 x, bronchial tubes feel sore ; 
dry cough, also, at commencement, may be 
given alternate with Aconite. 

Sambucus, 1 x, very useful for young 
children. 

Verat. Vir., 1 x, full, bounding pulse ; 
difficult breathing, also Antimonium Tart., 3 
x, Kali Bichromicum, 3 x, and Ipecac, 1 x. 

Keep the chest wrapped in cotton batting. 

Canker of the Mouth. — Merc. Cor., 3 x, 
one of the best remedies. 

Catarrh. — Aconite, 3 x, acute catarrh, 
feverishness ; pain in the head, eyes, nose, 
etc. 

Bryonia, 3 x, in addition to the acute 
catarrh of the nose, it has a dry cough with 
stitches in the chest. 

Kali Hydroidicum, 3 x, sneezing ; watery 
discharges from the eyes and nose which 
excoriates ; pain in the fore part of the head. 

Cessation of Menses. — At this time 
women are subject to "hot flashes." Lache- 
sis, 30, profuse menses from granular 
trouble of the mucous membrane and other 
troubles. At this time women needs the 
care of an able physician, and should consult 
him frequently, if everything is not perfectly 
normal. 

Chapped or Cracked Lips. — Bryonia, 3 x, 
dry, chapped lips. 

Chicken Pox (Varicella). — Aconite, 3 x, 



fever ; restlessness ; generally all the remedy 
needed. 

Antimony Tart., 3 x, if the eruption sup- 
purates, this remedy will be useful to prevent 
scars. 

Hepar Sulphur, 3 x, useful for a week or 
so after any of the eruptive diseases. 

Milk diet the best. 

Cholera Morbus. — Same remedies as 
Asiatic cholera, adding Colocynth, 2 x, for 
violent, griping pain in the bowels. 

Chronic Catarrh. — Calc. Carb., 30, Kali 
Bichromicum, 3 x, Sanguinaria, 3 x, Sulphur, 
cc. 

Colic — Colocynth, 3 x, is generally the 
first remedy called for. 

Plumbum Carb., 30, long continued colic 
with constipation. 

Chamomilla, 30, colic during dentition. 

Contcussion of the Brain. — Keep the 
patient quiet ; apply cold cloths to the head 
and give Arnica, 3 x, every hour or two, for 
a few days. 

Congestion of the Brain. — Belladonna, 
1 x, full, beating blood vessels ; full pulse ; 
red, flushed face ; mild delirium ; dilated 
pupils. 

Bromide of Potash, five grains, every 
hour, to an adult, until better. 

Veratrum Vir., 1 x, full, bounding pulse ; 
nausea with terrible pain in the head. 

Constipation. — Nux Vom., 3 x, where 
the trouble arises from an inaction of the 
muscular coats of the intestines. 

Opium, 30, stool hard, composed of small 
hard balls. Bry., 3 x, is given for alternate 
constipation and diarrhoea. If the child is 
taking cow's milk, salt it. Do not give 
physic ; and if the above remedies do not 
cure, go to a physician. 

Convulsions (Fits). — Belladonna, 3 x, 
flushed face ; throbbing of the blood vessels 
going to the head. 

Cicuta Virosa, 6 x, twitching and jerking 
of the muscles all over the body ; movement 
of the muscles about the mouth causing a 
chewing motion. 

Gelseminum, 1 x, violent fever ; full com- 
pressible pulse. The whole body is con- 
vulsed. 

Costiveness (Constipation). — Nux Vom- 
ica, 3 x or 30, useful after using much 
cathartic medicine ; persons of sedentary 
habits, no desire for stool, and, if there is, it 
cannot be accomplished. 

Plumbum, 30, stools of hard, small balls, 
frequent attacks of colic. 

Sulphur, cc, remedies do not give desired 
effect ; piles, with burning pain in rectum. 

Drink a glass of oatmeal water, every 
morning, on rising. 

Cough. — Aconite, 1 x, croupy cough ; 
spasmodic cough. 

Bryonia, 3 x, hard, dry cough, with pain 
in head and chest. 



678 



SPECIAL SYSTEMS. 



Belladonna, short, dry, hollow, convulsive 
cough, worse at night ; flushed face and 
cerebral congestion. 

Hepar Sulph., 3 x, irritating cough ; hoarse- 
ness, excited by exposure to cold. Rattling 
of mucus in the throat ; croup. 

Kali Bichro., 3 x, cough, with tough, 
stringy expectoration. 

Phosphorus, 30, dry cough with tickling 
in the throat. Worse from talking or read- 
ing aloud. 

Spongia, 1 x, dry, hoarse, croupy cough, 
with pain in the larynx. Alternate with 
Aconite, in croup, every fifteen minutes. 

Castanea Vesca, 1 x, five drops, every two 
hours, in whooping cough. 

Cuprum Aceticum, 30, also useful in 
whooping cough so violent as to often 
throw the patient into convulsions. (See 
also Asthma.) 

Cramp. — Cuprum Aceticum, 30, a very 
useful remedy. 

Cramp of the Legs. — Relieved by Cuprum 
Acet., 6 x. 

Cramp or Spasm of the Stomach (Gas- 
tralgia). — Dioscorea, 1 x, five drops every 
fifteen minutes. 

Nux Vom., 3 x, and even (j> , five drops, 
three times daily, will generally cure the 
disposition to cramp of the stomach. 

Bryonia, 3 x, useful if the cramp comes 
on immediately after eating. 

Lactopeptine, ten grains after each meal. 

Croup. — Aeon., 1 x, and Spongia, 3 x, 
alternately, for spasmodic croup. 

Defective Appetite. — Bryonia, 3 x, if 
caused by a torpid liver, also China, 6 x. 

Nux Vom., 1 x, from anxiety; overworked 
nervous system and constipation. 

Apply to a physician to ascertain cause. 

Delayed Menstruation. — If caused by a 
cold or wetting the feet at a previous period, 
give Aeon., 1 x, particularly if the patient 
is feverish and has congestion of the head, 
also in young girls who are away from home, 
at school, etc. 

Puis., 3 x, will generally restore the menses 
or bring them on when suppressed. 

Sanguinaria, 3 x, when delayed menses 
are accompanied by a cough, neuralgia of 
the head, bleeding from the nose and cramp 
in the stomach, etc. 

Senecin, 3 x, cough with suppression of 
the menses. 

Diabetes. — Uva Ursa, 1 x, ten drops every 
three hours in Diabetes Insipidus. 

Diabetes Mellitus. — Arsenicum, 3 x, 
very hungry and thirsty ; pale skin ; loss of 
strength ; dryness of mouth and throat ; ex- 
cessive urination ; watery diarrhoea. 

Phosphoric Acid, 1 x, loss of nerve force, 
with frequent urination. 

Gratify the thirst by an abundance of 
good water or skim milk. The diabetic 
should be warmly clad. 



Diarrhoea. — Camphor (p , sudden diarrhoea 
with chilliness. 

Dulcamara, 3 x, diarrhoea caused from 
getting wet ; worse at night, bilious stools. 

China, 1 x, painless, summer diarrhoea. 

Chamomilla, 30, diarrhoea in children, ac- 
companying teething. 

Arsenicum, 3 x, chronic diarrhoea; red, 
burning tongue ; vomits — even a small 
amount of water, in fact, everything taken 
into the stomach. 

Ipecac, 1 x, diarrhoea and dysentery ac- 
companied by much nausea. 

Veratrum Alb., 1 x, vomiting and diarrhoea 
attended with cold sweating ; cholera mor- 
bus ; cholera infantum. 

Avoid all animal food during an attack of 
diarrhoea. A little brandy may be added to 
milk with benefit. 

Dilatation of the Heart. — Digitaline, 3 
x, will strengthen a weak heart. 

Phosphorus, 3 x, valuable as a tonic, giv- 
ing tone to the system. 

Diphtheria. — Call your physician. Apis 
Mel., 3 x, in diphtheria with much swelling 
of the throat, internally, and a stinging pain. 

Phytolacca Dec., 1 x, violent fever, with 
much stiffness of the neck, early in the 
disease. 

Mercurius Cor., 3 x, much swelling of the 
throat externally ; the membrane is very 
offensive. 

Kali Bichromicum, 3 x, croupous diphthe- 
ria, with tough, stringy mucus. 

In connection with the Kali Bich., 3 x, use 
a spray of a solution of Chloride of Lime 
and hot water : one part of the solution to 
ten parts of hot water. Use a steam 
atomizer. 

Never swab the throat, but use gargles 
of alcohol and water. 

Diseases of the Heart. — Inflammatory 
diseases require Aeon., 1 x, for fever; quick 
wiry pulse ; pain and anguish, and with this 
may be alternated Bry., 3 x, if caused by 
rheumatic poison. 

Arsenicum, 30, burning pain, with effusion 
in the sack ; suffocative attacks ; coldness of 
the surface ; anxious and fears death. 

Cactus, 2 x, a feeling in the heart as 
though grasped by an iron hand. 

Veratrum Vir., 1 x, strong, loud beat of 
the heart, with difficult breathing ; bronchitis. 

Diseases Occurring During Pregnancy. 
— Morning Sickness (Nausea). This is 
generally relieved Dy Nux, 3 x, and to be 
given for faintness and nausea with con- 
stipation. 

Bry., 3 x, is also a valuable remedy, where 
the nausea begins or is made worse by 
moving about ; must lie in bed or she will 
vomit. This is a reflex action of the sym- 
pathetic nerves, the real cause being con- 
gestion and often ulceration of the uterine 
neck. A small amount of hot water (one 



HOMEOPATHY. 



679 



pint) may be used by vaginal injection once 
daily, to which may be added Hamamelis or 
Borax. 

Diseases of the Spinal Cord. — Seek 
professional advice at once. 

Aeon., 1 x, for the fever and anxiety. 

Gels., 1 x, patient is very nervous, with 
convulsions. 

Cicuta Virosa, 6 x, violent convulsions 
from irritability of the spinal cord. 

Dizziness (Vertigo). — Digitaline, 3 x, for 
dizziness caused by an enfeebled heart which 
has produced ansema of the brain. 

China, 1 x, caused by loss of blood or 
severe diarrhoea. 

Many other remedies are indicated from 
special causes which can only be located by 
a physician. 

Dropsy. — Arsenicum, 3 x, a very useful 
remedy in dropsy with much debility ; red 
tongue and much thirst for cold water, but 
a small amount satisfies. 

Digitaline, 3 x, heart dropsy, more parti- 
cularly, but useful in any kind, from what- 
ever cause. 

Helleborus Nig., 3 x, dropsy of the brain ; 
after scarlatina, etc. Skim-milk diet useful 
in dropsy from kidney disease. 

Dysentery. — Aconite, 1 x, very feverish; 
quick, wiry pulse at the commencement of 
the trouble ; if the discharges are principally 
of blood, alternate with Merc. Cor., 3 x, 
every half hour. 

Ipecac, 1 x, nausea and vomiting, with 
bloody, greenish stools ; it also quiets tenes- 
mus. 

Arnica, 3 x, dysentery, attended by much 
urging to go to stool. Injections of very hot 
water, after each stool, will relieve. Avoid 
all animal food ; cold milk best article of 
diet. 

Dyspepsia (Indigestion). — Arsenicum, 3 
x, caused by ice cream ; burning in stomach : 
red tongue ; thirst ; the least swallow of 
food or drink causes pain. 

Bryonia, 3 x, sense of pressure as from 
a hard lump in the stomach ; bitter taste 
with headache. 

Carbo Veg., 3 x, much gas in stomach. 

Hydrastis, 1 x, for pain coming in two or 
three hours after meals. 

Lactopepiine, five to ten grains after each 
meal, is useful to help the stomach until it 
regains its functions. Eat slowly, masti- 
cating the food thoroughly. Avoid such 
articles of food as are known to disagree. 

Earache (Otalgia). — Aconite, 1 x, from 
cold; patient very restless. 

Puis., 3 x, steady pain, but does not drive 
the patient about as Aconite does. 

Aconite, £>, two or three drops on cotton, 
in the ear, very useful. 

Tobacco smoke, blown into the ear, will 
ease the pain. 

Enlargement of the Uvula, which is 



relaxed, Hyoscyamus, 1 x, every two hour^. 
A tea of Gold Thread useful as a gargle. 

Epilepsy (Falling Fits). — To ward off an 
attack use Nitrite of Amyl, by inhalation. 

Bell., 3 x, holds a high place in chronic 
epilepsy of young and full blooded subjects. 

Cuprum Acet., 30, violent convulsions; 
pale face. 

Nux Vom., 3 x, useful as a tonic to the 
nervous system. 

Erysipelas. — Aconite, 1 x, erysipelas of 
the face, with a quick, wiry pulse. 

Belladonna, 3 x, intense redness of the 
skin ; high fever ; smooth surface ; violent 
headache ; delirium. 

Rhus Tox., 3 x, vesicular, purplish colored 
skin. Powder with dry starch or flour. 

In the phlegmonous variety, call a physi- 
cian. 

Exhaustion. — If caused by hemorrhage, 
diarrhoea, etc., nothing is better than China, 
1 x. If from non-assimilation of food, give 
Calc. Phos., 3 x. 

Arsenicum, 3 x, useful for indigestion, 
with burning of the stomach, also from the 
effects of typhoid fever. 

Phosphoric Acid, 1 x, nervous exhaustion 
from excesses. Beef tea is useful ; use also 
milk. 

Eyes. — For simple inflammation of the 
eyes, the white of the eye being red, give 
Bell., 3 x, every two hours. For hot, scald- 
ing, watery discharge from the eyes, Kaii 
Hydroidicum, 3 x. A cinder or any foreign 
body in the eye should be early removed. 
Any trouble causing severe pain in the eye 
is serious, and an oculist or good surgeon 
should be consulted. 

Fainting (Syncope). — Aconite, 30, the 
best remedy to prevent its frequent occur- 
rence. Aqua Ammonia or Spirits of Cam- 
phor, by inhalation, are restoratives ; also 
sprinkling water in the face. 

Falling off of the Hair. — Silicea, 30, 
will stop the hair from falling off after a 
severe sickness, which has caused debility. 
At the same time a wash of Bay Rum and 
water, two ounces of each and Aqua Ammo- 
nia, one drachm, will be found useful. 

Falling of the Womb. — A result of 
either a ruptured perineum or an increased 
weight from above (tumors, enlargement, 
etc.). The treatment is principally mechan- 
ical and surgical. 

Lilium Tig., 30, much used in these 
troubles. 

Felons. — Belladonna, 3 x, for redness of 
the finger, with throbbing pains after sup- 
puration has taken place. Hepar Sulph., 3 
x, will hasten a cure. Have it opened, 
early ; by so doing you will save much suf- 
fering, and, possibly, the loss of a finger. 

Fevers, in General. — Aconite, 1 x, give 
the remedy when you find a quick, firm, 
hard, wiry pulse. 



68o 



SPECIAL SYSTEMS. 



Baptisia Tinct., 1 x, give this for a quick, 
fine, soft, compressible pulse; typhoid fever; 
diarrhoea, etc. 

Gelseminum, 1 x, give for a full, bounding 
pulse, that is compressible and does not 
resist the finger. 

Veratrum Vir., 1 x, full, hard, incompres- 
sible pulse and resists the finger. 

Fever axd Ague (Intermittent or Ma- 
laria). — China, Quinine, in recent ague, 
never in chronic cases, all the stages are well 
marked, the chill is usually in the morning 
from nine to ten. 

Arsenicum, 3 x, chronic ague; one stage 
runs into another, often one stage is left 
out ; very thirsty ; rapid and excessive 
prostration ; dropsical swellings. 

Eupatorium Perf., 1 x, thirsty several 
hours before a chill and continues through 
it ; short chilly stage ; long hot stage and 
slight sweating. 

Phos. Acid, 1 x, very profuse sweat. 

Gels., 1 x, severe nervous symptoms. 

Natrum Mur., 30, chronic ague. Arseni- 
cum, 30, Ipecac, 3 x, Cedron, 3 x, Sulph., 30, 
for dumb ague. 

Foetid Breath. — Salicylic Acid, 3 x, a 
powder, three times daily, will correct it, 
when the stomach is at fault. Decayed 
teeth should be filled or removed. 

Gallstones. — Where a person is known 
to suffer from these concretions, give six 
tablespoonfuls of Olive Oil, at bedtime, 
repeated in two days, at the same time give 
CJiina, 6 x, a dose three times daily, and it 
will rarely fail to cure. An anesthetic will 
give the only relief while they are passing 
through the gall duct. 

Gangrene, Mortification. — Remove it 
when possible by amputation, if it be of a 
limb, from injury. A superficial slough can 
be treated by a flaxseed meal poultice, to 
which add charcoal. A poultice made from 
crushed, boiled carrots, is also a good one. 

Internally, give Arsenicum, 3 x, every two 
hours, if there is much burning about the 
slough. 

Secale, 3 x, for dry gangrene of the toes. 
A weak solution of Carbolic Acid, ten drops 
to one pint of hot water, should be used as 
a wash. 

Glandular Swellings. — When as a result 
of diphtheria, put on salt pork, and give 
Merc. Protoide, 3 x, internally. When from 
a cold, Hepar Sulph., 3 x, is generally the 
remedy. If from scrofula, Calc. Phos., 3 x, 
and Calc. Iodide, 3 x, are the best remedies. 

Gout. — The leading remedy is Colchicum, 
1 x, five drops every three hours ; avoid 
highly seasoned and animal food, liquors of 
all kinds. 

Gumboil. — Bell., 1 x, will often remove 
the inflammation that leads to i gumboil. 

Merc. Viv., 3 x, when caused by a decayed 
tooth. 



Open as soon as pus forms. 

Hay Fever (Asthma). — Arsenicum, 30, is 
the chief remedy. Sanguinaria Nitrate, 3 x, 
will often help when there is severe sneezing 
and a watery condition of the eyes. 

Headache. — Bilious or sick headache will 
call for Iris Vers., 3 x, or Cocculus, 30, at the 
time of the pain, taking China, 30, or Nux 
Vom., 3 x, twice a day at other times. Con- 
gestive headache requires Bell., 3 x, if with- 
out vomiting; if with vomiting, Veratrum 
Vir., 1 x, at the time. During the interval, 
take Sanguinaria, 30, or Pulsatilla, 30. 

Hiccough (Spasm of the Diaphragm). — 
A few drops of vinegar on sugar will gener- 
ally control it. Moschus, 3 x, is the homoeo- 
pathic remedy. If occurring during the 
course of a severe illness, a tight bandage 
across the chest oftentimes prevents its 
reappearance. 

Hip Joint Disease (Coxalgia). — Bell., 3 x, 
when there is soreness about the joint dis- 
covered by pressure. 

Calc. Carb., 30, twice daily; should be 
given steadily to correct the strumous con- 
dition. 

Calc. Iod., 3 x, and Calc. Phos., 3 x, for 
the same condition. 

If from an injury, Arnica, 3 x, may be the 
most useful remedy. The joint should be 
placed at rest by patent splints, and the 
child placed under the care of a reputable 
surgeon. 

Hoarseness. — Causticum, 30, from singing 
and over-use of the voice. 

Spongia, 3 x, or Kali Bich., 3x, when 
caused by croup. 

Phos., 30, from the effects of a cold, 
always worse in the evening. 

Hypochondria (See Hysteria) . — Nux 
Vom., 3 x, the most useful remedy. 

Hysteria. — This is a perverted nervous 
action, generally arising from uterine or 
ovarian disease, and the cause must be 
found and properly treated to lead to a cure. 

Gels., 1 x, very nervous, with hysterical 
convulsions. 

Moschus, 3 x, useful in many of the symp- 
toms, such as palpitation of the heart, cramp 
of the stomach, neuralgia, etc., of hysterical 
subjects. 

Hysterical Convulsions. — Nux Vomica, 
3 x, violent drawing backward of the head 
and feet toward each other. 

Convulsions from passion, Chamomilla, 30 : 
injury, Hypericum, 1 x: worms, Cina, 3 x, 
Cicuta, 6 x : fright, Ignatia, 30. 

Incontinence of Urine. — Wetting the 
bed is very common during childhood. If 
caused by worms, or intestinal irritation, 
Cina, 30, will benefit. 

Ferrum Acet., 3 x, in delicate blonde 
children. 

Equisetum Hyemale, 3 x, is also a useful 
remedy to break up the habit. 



HOMEOPATHY. 



Inflammatory Blush (Erythema). — Bell., 
3 x, all the remedy required generally. 

Inflammation of the Ear (Otitis). — 
Aeon., 1 x, fever caused by cold. Puis., 
3 x, alternately with the Aeon. 

Hepar Sulph., 3 x, should an abscess 
develop. 

Inflammation of the Eye (Ophthalmia). 
— Aeon., 1 x, from cold ; feverishness. 

Bell., 3 x, acute redness of the conjunctiva 
or white of the eye. Keep hot compress on 
the eye, to wh*ich may be added Bell.ty , ten 
drops to a teacupful of hot water ; compress 
to be wet in this solution. Use no eye 
washes. If not better in a few days, call 
your physician, for, if the deeper tissues are 
affected, you cannot diagnose it. 

Inflammation of the Bladder (Cystitis). 
— Aconite, 1 x, acute pain, with fever, alter- 
nating with Cantharides, 3 x, which has 
constant or frequent desire to urinate, fol- 
lowed by severe pain. 

Apis Mel., 3 x, stinging pain, when 
passing water, in the bladder. If the inflam- 
mation is caused by Spanish-fly blister, with 
severe strangury give Camphor <p , ten drops, 
every quarter hour, until better. Hot ap- 
plications over the lower part of the abdomen 
should be made. 

Inflammation of the Kidneys. — Aeon., 
1 x, feverish ; quick, wiry pulse ; restlessness. 
Turpentine, 1 x, high colored urine, scanty, 
sometimes bloody. Pain over region of the 
kidney. 

Aconite, 1 x, alternating with Turpentine, 
1 x, are generally all that are called for in 
acute inflammation of the kidneys. 

Inflammation of the Larynx (Laryngi- 
tis). — Aconite, 1 x, for fever with croupy 
cough ; restlessness. 

Kali Bich., 3 x, if the Aconite does not 
succeed, this remedy generally will. Its use 
will be needed if there is an expectoration 
of stringy mucus. This is the remedy, par 
excellence, for membranous croup. 

Spongia, 1 x, may be given alternately 
with Aconite at first. 

Hepar Sulph., 3 x, a powder every four 
hours, very useful when the violence of the 
attack has subsided, leaving a rough, hoarse 
cough. 

Tracheotomy may be called for where 
there is fear of suffocation ; but when 
homoeopathic remedies are given this is 
rarely essential. The steam atomizer may 
be called for also. 

Inflammation of the Liver. — Aeon., 1 
x, pain in the region of the liver, with high 
fever ; quick, wiry pulse ; restlessness. 

Bryonia, 3 x, pain in the liver, worse upon 
movement ; nausea and vomiting ; yellow 
coating on tongue. 

China, 6 x, one of the most frequent 
remedies called for in congestion of the 
liver. 



Podophyllum, 1 x, chronic diarrhoea, worse 
in th«j morning, caused by an inactive liver. 

Merc. Prot., 3 x, jaundice; yellow coated 
tongue ; nausea, and often vomiting. 

Phosphorus, 3 x, loathing of food, which, 
if swallowed, creates disturbances and is 
vomited after a few minutes. 

Inflammation of the Ovaries (Ovaritis). 
— Aeon., 1 x, and Puis., 3 x, alternately. Hot 
applications externally, and very hot vaginal 
injections. 

Apis Mel., 3 x, if the pain is stinging, 
worse on the right side. Clematis, 30, i 
deathlike, sickening pain. Lach., 30, left 
sided pain. 

Inflammation of the Peritoneum (Peri- 
tonitis). — A very dangerous disease; call 
your physician early. 

Aconite, 1 x, from cold febrile symptoms 
with quick, firm pulse. 

Veratrum Vir., 1 x, full, hard, bounding 
pulse ; vomiting and often diarrhoea. 

Belladonna, 3 x, sharp, cutting pains in 
the bowels, which come quickly, and disap- 
pear as rapidly as they come. 

Bry., 3 x, second stage, exudation ; pain 
in the bowels, aggravated from motion ; 
tongue coated and dry ; great thirst. 

Colocynth, 2 x, severe, griping pain in the 
bowels. Ars., 3 x, sudden sinking and 
prostration ; restlessness ; great thirst ; 
tongue red. Keep the patient at rest, and 
use hot fomentations over the bowels. 

For intense thirst and vomiting, small bits 
of ice are useful. 

Inflammation of the Spleen. — Quinine., 
1 x, is the only remedy usually called for. 

Inflammation of the Stomach (Gastri- 
tis). — Arsenicum, 3 x or 30, inflammation of 
the mucous membrane of the stomach, known 
by violently red tongue ; burning pain in the 
stomach, and vomiting as quickly as any 
food enters the stomach. 

Argentum Nit., 3 x, inflammation of the 
stomach, caused by ulcer of the stomach. 
Much gas in the stomach, with violent pain 
after eating. The diet should be of the 
simplest ; milk, or milk and limewater. 

Inflammation of the Tonsils (Tonsili- 
tis, Quinsy). — Bell., 1 x, the first remedy 
thought of in quinsy. It may be followed 
by Merc. Prot., 3 x, if the inflammation 
does not subside in forty-eight hours. 
Should the tonsil suppurate, give Hepar 
Sulph., 3 x. Gargle the throat with hot 
water frequently. 

Inflammation of the Tongue (Glossitis). 
— Bell., 1 x, painful swelling of the tongue. 

This should be followed in forty-eight 
hours by Merc. Viv., 3 x, if not better. 

Inflamed or Ulcerated Nose. — Kali 
Hyd., 3 x, the only remedy usually called for. 

Influenza. — Aconite, 1 x, alternating with 
Eupatorium Perfoliatum, 3 x, for lameness 
and stiffness of all the muscles, joints, etc. 



682 



SPECIAL SYSTEMS. 



Bry., 3 x, will be called for later, where 
there is pain in the head ; dry cough and 
pain in the chest. 

Bell., 3 x, violent headache ; red face ; sore 
throat ; redness of the eyes, etc. 

Irritable Bladder (Frequent Desire to 
Make Water). — Cantharis, 3 x, will gener- 
ally relieve. If the pain is stinging, give 
Apis Mel, 3 x. 

Irritation of the Bladder. — Most fre- 
quent in women who have uterine displace- 
ments, and congestion of the neck of the 
womb. This should be corrected before any 
remedy will help, then give Canth., 3 x, for 
frequent calls to urinate. 

Sepia, 30, pain after urinating, with 
uterine congestion. Hot vaginal injections 
very good. 

Irritation of the Skin, Itching (Pruri- 
go). — It may call for a variety of remedies. 
Rhus Tox., if it is a burning itching, worse 
in bed. 

Urtica Urens, 3 x, stinging, burning 
itching, which comes and goes frequently ; 
nettle rash. 

Arsenicum, 3 x, chronic itching of the 
skin, which is scabby and dry. See a phy- 
sician. 

Irritation of the Spine. — Unless the re- 
sult of an injury, is generally complicated by 
some uterine disorder. 

Gels., 1 x, very useful where the patient 
is extremely nervous and sleepless ; full 
pulse. 

Nux Vom., 3 x, stiffness and rigidity of 
the spine ; indigestion ; constipation ; pain 
in the back of the head and neck. Dry 
Clipping and wet compresses to the spine 
are often most useful. Go to your physician 
and find the cause, and treat it from that 
point. 

Itch (Scabies). — Sulphur Ointment, exter- 
nally, use a week, every night on going to 
bed, at the same time take Sulphur, cc, 
internally. 

Itching of the Genital Organs (See 
Pruritus). — Ars., 3 x, Merc., 3 x, Rhus Tox., 
3 x, all good. 

Jaundice. — Aconite, 1 x, feverish and 
restless. 

Bry., 3 x, congestion of the liver ; yellow, 
thick coated tongue ; thirst and headache. 

China, 6 x, result of gallstones, or a 
thickened condition of the bile ; obstruction 
of the gall duct, very useful in malarious 
climates. 

Phos., 3 x, indigestion ; vomiting of food 
about ten minutes after it is taken. 

Merc, 3 x, and Pod., 1 x, may be called 
for later, if the trouble does not respond to 
the other remedies. Jaundice is generally 
caused by some organic disease of the liver. 

Jaundice of Infants. — Aeon., 3 x, will be 
useful if the child is feverish and very 
restless. 



China, 6 x, constipation, with much bile 
in the system. 

Merc, 6 x, skin very yellow ; stools white 
(clay color). 

Phos., 30, one of the best remedies when 
the child has a hacking cough. 

Lice. — Apply oil of Bergamot to the scalp. 

Lockjaw (Tetanus). — The result gener- 
ally of an injury to a nerve. The wound 
should be opened, and if the nerve can be 
found it should be divided. 

Gels., 0, and Veratrum Vir., <f>, sixty drops 
of each added to two glasses each half full 
of water, and giving a teaspoonful every 
quarter hour, has relaxed the muscles and 
cured many cases. The disease is fatal in 
a large per cent of cases. 

Lumbago. — Rhus Tox., 3 x, if from getting 
wet or a strain. 

Measles. — Usually a very mild disease ; 
particularly under homoeopathic treatment. 

Aeon., 3 x, during the first two or three 
days. Sneezing ; hacking cough ; fever and 
restlessness. 

Bell., 3 x, much pressure of blood to the 
brain ; mild delirium. 

Cuprum Acet., 30, sudden disappearance 
of the eruption when only partially out. 

Puis., 3 x, much running of a watery fluid 
from the eyes and nose ; cough ; diarrhoea, 
etc., one of the best remedies in this disease. 

Sambucus, 1 x, if there is much bronchitis, 
give this remedy. 

Hepar Sulph., 3 x, toward the end of the 
disease, to prevent sequelae The same 
remedies are used in malignant or Black 
Measles, but a physician should be called, 
for any remedy in the Materia Medica may 
become necessary. 

Membranous Croup. — Kali Bich., 3 x, the 
best remedy. A Solution of Chloride of 
Lime, by inhalation. It often becomes 
necessary to perform tracheotomy. 

Milk Fever. — Seldom requires much, but 
if severe give Aeon., 1 x. Should the brain 
suffer and the patient talk in her sleep, Bell., 
3 x, will be suitable. 

Milk Leg (Phlegmasia Dolens). — Aeon., 
1 x, and Puis., 3 x, alternately, will often 
cut an attack short at the beginning. Ex- 
tract of Hamamelis is a good application, 
locally. 

Mumps (Parotitis). — Aeon., 1 x, Puis., 3 
x, and Merc, 3 x, are the remedies. 

Avoid taking cold and other remedies will 
not be needed. 

Nausea. — Ipecac, 1 x, is generally all the 
remedy needed. Violent nausea and vomit- 
ing, when not controllable by ipecac, may 
find a remedy in Antimony Tart., 3 x. 

Neuralgia. — Aeon., 1 x, from cold, with 
fever, in teeth and face. 

Bell., 3 x, pain in the teeth and face, more 
particularly on the right side ; red, flushed 
face. 



HOMEOPATHY. 



683 



Colocynth, 2 x, severe pain on left side of 
face. 

Ars., 3 x, pain as of hot needles piercing 
through the skin ; cases of a chronic na- 
ture. 

Cheledonium Maj., 3 x, pain in right 
shoulder and side. 

Phos., 3 x, severe, long-continued neural- 
gia of any part of the body. The application 
of heat is very beneficial. 

Galvanism will often hasten the cure of 
the remedies. 

Neuralgia of the Heart (Angina Pec- 
toris). — Amyl Nitrite, by inhalation at time 
of attack. 

Ars., 3 x, a very useful remedy to prevent 
the recurrence of an attack. Smoking should 
be stopped by those who suffer from the 
disease. 

Nightmare. — A dose of Nux Vom., 3 x, 
at bedtime will usually overcome the trouble. 

Noises in the Ear (Tinnitus Aurium).— 
One of the best remedies is Puis., 3 x, for 
this trouble. 

China, 1 x, for noises in the ear as a 
result of losing a large amount of blood. 
Ear wax should be removed by putting a few 
drops of glycerine in the ear at night, for 
two or three times. 

Obstructed Menses. — May be malforma- 
tion and need the care of a surgeon. When 
caused by congestion, Bell., 3 x, is the proper 
remedy. Hot vaginal injections, containing 
a few drops of Fluid Extract of Belladonna, 
may also be used. 

Painful Menstruation (Dysmenorrhea). 
— A very common trouble in flexions of the 
womb and disease of itself or its appen- 
dages. If acute and caused by a cold, Aeon., 
3 x, will be the remedy. Puis., 30, will be 
found to be an admirable remedy at the time 
of the pain, when ovarian. 

Thuja Oc., 1 x, once a day during the 
intervals ; congestion of the ovaries ; a 
flexion should be overcome ; a narrow canal 
should be enlarged. 

Pains in the Side. — Relieved by Aeon., 
1 x, and Bryonia, 3 x. 

Painter's Colic. — Opium must be ad- 
ministered in one grain doses, every two 
hours, until better. 

Kali Hydroidicum, 1 x, useful to eradicate 
the lead from the system. 

Palpitation of the Heart. — Aeon., 3 x, 
when the result of fright ; severe and pro- 
longed anxiety. 

Cactus Grand., 3 x, when due from fatty 
heart. 

Coffea, 3 x, nervous palpitation. 

Moschus, 3 x, severe and acute attacks. 

Agaricus, 3 x, if due from excessive use 
of tobacco. 

China, 3 x, if from tea drinking. 

Palsy (Paralysis). — When acute, follow- 
ing an attack of apoplexy, Arnica, 3 x, will 



hasten the absorption of the blood in the 
brain. 

Nux Vom., 3 x, and Gels., 1 x, will restore 
the nerve stimulus to the affected muscles in 
many cases. Faradization is very useful. 

Papulous Scall (Eczema). — The reme- 
dies most generally used are Croton Tig., 30, 
for ulcerating skin. 

Rhus Tox., 3 x, severe itching, with 
thickened, red skin. 

Canth., 3 x, vesicular (watery) blisters on 
the skin. 

Graph., 30, dry, cracked skin. 

Ars., 3 x, old, chronic cases ; dry, fish scaly 
skin. 

Sulphur, cc, will benefit cases which have 
become chronic and do not respond to the 
other remedies. Ointments generally aggra- 
vate the trouble. 

Paralysis, Agitans (Shaking Palsy).— 
Should be treated by a physician, as well as 
Paraplegia (paralysis of the lower extremi- 
ties), as they arcgenerally caused by some 
deep seated disease of the nerve centers. 

Periodic Headache (Malarial). — May re- 
quire Quinine to break it up : one dose of 
five, ten, or fifteen grains, the night before 
an expected attack, followed by Ars., 3G, 
once daily for a month or so. At the time 
of pain no remedy can equal Gelseminum, 
1 x. 

Headache from a diseased condition of the 
brain will require Zinc Phos., 3 x, and 
sedatives prescribed by a physician. 

Headache of young persons of sedentary 
habits, free indulgers at the table, can be 
promptly helped by Nux Vom., 3 x, one dose 
daily, at bedtime. Nearly all forms are 
curable by homoeopathic treatment. 

Piles (Hemorrhoids). — Aesculus Hip., 3 
x, pain in the back ; constipation and piles. 

Collinsonia, 1 x, very useful for piles that 
protrude, with constipation. 

Hamamelis, 1 x, bleeding piles, both in- 
ternal and external. 

Nux Vom., 3 x, and Sulphur, 30, have 
cured many cases, in alternation, Sulph. in 
the morning and Nux at night. Suppositories 
made from the above remedies are also very 
useful. 

Pleurisy (Pleuritis).— Aconite, 1 x, and 
Bry., 3 x, alternately. Aeon., 1 x, during 
the first two or three days, with fever, fol- 
lowed by Bry., 3 x, for four or five days, 
and later, Sulphur, cc, to finish up the case. 
Hot poultices should be applied to the chest. 

Profuse Menstruation (Menorrhagia). 
— Calc. Carb., 30, the remedy most useful in 
the large majority of cases. Never take iron 
in. such cases. If the above does not help, 
go to a physician for examination. One of 
the most frequent symptoms of polypus, 
Hbfoid tumors, granular degeneration of the 
mucous membrane of the womb, and even 
cancer, is the profuse menses. When the 



684 



SPECIAL SYSTEMS. 



flow continues all the time, and stops for a 
day or two and again returns (Metrorrhagia), 
depend upon it, your case needs the attend- 
ance of a specially trained physician. 

Prolapse of the Rectum. — Nux Vom., 3 
x, three times daily, will help it, also Podo- 
phyllum, 3 x, in the same way. It is often 
necessary to wear an instrument for a time. 
Go to a surgeon. 

Puerperal Fever. — A blood poisoning 
caused by absorption of offensive or putrid 
material, either by an abrasion of the vaginal 
tract, or through the uterine blood vessels. 
It should be prevented by using a warm 
vaginal injection, every twelve hours, con- 
taining a little Calendula, for two weeks. 
If at any time the lochial discharge becomes 
offensive, use Carbolic Acid enough to scent 
the water, and give Kreasotum, 4 x, inter- 
nally. Aeon., 1 x, Bell., 3 x, Ars., 3 x, 
Verat. Vir., 1 x, Baptisia <j> , or 1 x, Rhus 
Tox. and Radicans, 3 x, and many other 
remedies are used, but without the proper 
cleansing of the vaginal tract, they are of 
little use. 

Purulent Ophthalmia. — Merc. Sol., 3 x, 
and Sulph., cc, will be all the remedies 
needed, generally. An eye wash of Nitrate 
of Silver, one-half grain to the ounce of 
water, should be used twice daily, until 
better. 

A towel used by a person suffering from 
this disease should not be used by others, as 
the disease is infectious. 

Retention, Suppression and Difficulty 
of Voiding the Urine. — Apply hot cloths 
over the kidneys, and give Aeon., 3 x, every 
hour. 

Canth., 3 x, will often succeed when Aeon. 
fails. The case should be examined for 
any malformation. 

Rheumatism. — Aconite, 1 x, characteristic 
fever, caused by cold ; pain and restlessness. 

Bry., 3 x, swelling of the joints, which are 
very painful and worse from moving about. 

Merc. Viv., 3 x, obstinate inflammation of 
single joints, worse at night; deep pain, as 
if it were in the bones ; profuse perspiration, 
but not relieved by it. 

Puis., 3 x, subacute cases with little fever ; 
pains shift rapidly from one joint to another. 

Rhus Tox., fever ; parts red and swollen ; 
pains drawing, tearing, burning, feels worse 
when at rest and better from continued 
motion. Worse damp or wet weather. 

Wrapping the swollen joints with cotton 
batting relieves the pain very much. A 
solution of Bicarbonate of Soda and hot 
water, for bathing, is also useful. 

Rheumatic Headache. — Calls for Bry., 3 
x, if worse by moving about and better at 
rest, but if better moving about and worse 
at rest, Rhus Tox., 3 x. 

Salicine, five grains every two hours, may 
be given with one of the other remedies. 



Rickets. — Calc. Carb., 30, and Calc. lod., 
3 x, Kali Tod., 3 x, Iodine, 3 x, are the prin- 
cipal remedies for this defect of osseous 
nutrition. 

Ringworm (Herpes Circinatis). — Sepia, 
30, one dose daily, for a week, will cure. 
Cantharides <(> , locally, also will cure. 

Running of the Ear. — Apply to a sur- 
geon. 

Merc, 3 x, and He par Sulph., 3 x, inter- 
nally. 

Scarlatina Anginosa. — Apis Mel., 3 x, 
great swelling of the throat, so much so that 
the blood cannot flow freely to and from the 
brain, which causes a comatose condition. 

Merc. Iod., 3 x, great swelling of the 
glands about the throat externally ; ulceration 
of the throat. 

Scarlet Fever or Scarlatina. — Simple 
scarlet fever should be treated by Aeon., 1 x, 
if there be much fever, with wiry pulse ; 
restlessness, etc. 

Bell., 3 x, is almost a specific for this 
form. It has red face ; sore throat ; slight 
delirium. 

Rhus Tox., 3 x, much itching of the skin 
in connection with the symptoms under 
Aeon, and Bell. 

Scarlatina Maligna. — Ailanthus, 1 x, 
very malignant cases, violent vomiting ; se- 
vere headache ; dark, red face ; rapid, small 
pulse ; high temperature ; muttering deliri- 
um ; dark, livid, miliary rash. 

Cuprum Acet., 30, pudden retrocession of 
eruption, followed by vomiting ; convulsions ; 
rolling of eyes ; distortion of face ; stupor 
and delirium ; brain severely affected. 

Muriatic Acid, 1 x, severe ulceration of 
the throat. 

For Nephritis and Dropsy, following scarlet 
fever, Ars., 3 x, Asclepius Syrica, 3 x, Apis 
Mel., 3 x, and Terebinth., 1 x, are the 
remedies. 

Give all other children in the house Bell., 
3 x, who have been exposed to the disease. 
The diet should be principally milk. All 
acids should be excluded. Keep a careful 
watch of the patient for a month or more 
and the child should not be allowed to return 
to school for, at least, six weeks. 

Sciatica. — Aeon., 1 x, fever, with rest- 
lessness, caused by a cold. 

Bry., 3 x, pain is increased or brought on 
by movement. 

Cimicifuga, 1 x, drawing, tearing pain over 
the course of the sciatic nerve. 

Rhus Tox., 3 x, pain is better from 
warmth and worse during stormy and wet 
weather, better from shifting one's position. 

Bry. and Rhus are the chief remedies. 

Galvanism should be resorted to if the 
trouble does not yield readily to medicine. 

Scrofula (King's Evil). — Calc. Carb., 30, 
Calc. Iod., 3 x, Iodine, 3 x, Kali Hydroid., 
3 x, Sulphur, cc 



HOMEOPATHY. 



68 S 



Calc. Carb., 30, for fair skinned, plump, 

waxy children ; teeth delayed ; swollen 

glands ; discharges from eyes, ears, nose, etc. 

Calc. Iodide, 3 x, same as Calc. Carb., 

when the latter does not succeed. 

Iodine, 3 x, glandular enlargements, with 
wasting of the muscular tissue. Child is 
very thin in flesh. Mesenteric glands en- 
larged. 

Kali Hydroid., 1 x, little nodules under 
the skin ; lymphatic system involved deeply ; 
disease of the bones, etc. 

Cod-liver oil is often useful in those cases 
that are especially emaciated, and who do 
not seem to assimilate food, yet plenty is 
taken ; it should not be taken if fever is 
present. 

Scurvy. — Citric Acid, 1 x, or lemon juice, 
the best remedies. 

Kali Bich., 3 x, salivation with sore gums 
and hemorrhage under the skin. 

Acid Sulphuric, dilute, five drops every 
three hours, for hemorrhage from mouth, 
stomach, or bowels. The diet should con- 
sist of fresh meat, vegetables, and milk. 

Sea-Sickness. — Cocculus, 30, the great 
remedy for sea-sickness, either from vessel 
sailing, car or carriage riding. 

Simple Inflammatory Fever. — Rarely re- 
quires anything more than Aeon., 3 x. 

Slow or Nervous Fever. — Bryonia, 3 x, 
yellow coating on tongue ; constipation ; pain 
in the right side of the head ; lips dry and 
cracked. 

Nitric Acid, 3 x, torpid, sluggish liver ; 
sallow complexion ; acid or bitter taste in 
the mouth, when the fever has continued 
thirty or thirty-five days without recovery. 

Hyoscyamus Nig., 1 x, for sleeplessness 
during nervous fever. Bathe the patient 
with a solution of Bicarbonate of Soda and 
hot water, once daily. 

Snuffles, or Cold in the Head. — Aeon., 
3 x, and Bry., 3 x, are the remedies most 
generally useful. Kali Iod., 3 x, also an 
admirable remedy. 

Sore Mouth (Aphtha). — Ars., 3 x, and 
Merc, 3 x, are the remedies, internally. Use 
a wash of Golden Seal, fluid extract, one 
part to ten of water. 

Sore Nipples. — Give Silicea, 30, inter- 
nally, and apply Calendula <p , one part to ten 
of flexible Collodion, over the cracks or 
ulcers. 

Spasm of the Glottis. — Aeon., 1 x, is all 
the remedy needed generally. 

Squinting. — If from brain irritation, 
Cimic, 3 x, and Zinc, 30, will benefit. From 
contracted muscle, a surgical operation. 

Stiff Neck. — If caused from sitting in a 
draught, give Aeon., 1 x. 

Rhus Tox., 3 x, from getting wet. 
Lachnanthus, 3 x, stiff neck, following 
diphtheria. Faradization will promptly re- 
lieve. 



Stitch in the Side. — Aeon., 1 x, effects 
of a cold; rheumatism of the muscles of the 
chest. 

Bry., 3 x, dry cough, with stitches in the 
chest. 

St. Vitus' Dance (Chorea). — The leading 
remedies are Ignatia, 30, Cimicifuga, 3 x, 
Arsenicum, 3 x, Ferrum, 1 x, Cuprum, 30, 
Zinc, 30. If the result of a fright, give 
Ignatia, 30 : if from debility, Ferrum : if from 
rheumatism, Cimicif., 3 x : if from brain and 
spinal lesions, Cuprum, 30, and Zinc, 30. 

Galvanism should be used at the same 
time. 

Styes (Hordeolum). — Puis., 3 x, will 
generally stop them. A course of Sulphur, 
cc, will prevent a recurrence. 

Suppression of Urine. — Apply hot appli- 
cations over the region of the kidneys, and 
give Aeon., 1 x, and Terebin., 3 x, alter- 
nately. 

The hot pack will be useful also. 
Teething. — Calc. Carb., 30, will generally 
advance the teeth when they are delayed. 

Kreasotum, 4 x, often relieves the sen- 
sitiveness of the gums and reflex nervous 
excitement. 

Chamomilla, 30, child is very nervous and 
cries often ; colic and diarrhoea. 

Thrush (Aphthas). — Ars., 30, when it 
occurs during the course of a debilitating 
disease. 

Merc. Cor., 3 x, occurs suddenly, without 
previous symptoms. 

Hydrastis, 1 x, lingers and does not read- 
ily disappear ; stomach out of order. 

Toothache. — Aeon., 1 x, when from cold. 
Bell., 1 x, with red, flushed face, and 
pressure of blood to the brain. 

Merc., 3 x, tendency of the tooth root to 
ulcerate. 

Typhoid Fever. — Baptisia, 1 x, alternating 
with Gelseminum, 1 x, will abort a Typhoid 
Fever, if given soon enough. 

Bry., 3 x, violent headache ; restless sleep ; 
tongue coated yellow, with dry, parched lips ; 
great thirst for large quantities of water. 
Should not be used after diarrhoea sets in. 

Mercurius, 3 x. Tongue loaded with a 
thick, moist, creamy coating ; painful sen- 
sibility of the whole abdomen ; bloody 
stools ; sweating without relief. 

Rhus Tox., 3 x. Temperature high ; 
tongue dry ; dark coating on tongue and 
teeth ; delirium ; headache ; nose bleed ; de- 
bility and prostration ; pulse weak and slow ; 
abdomen bloated; frequent diarrhoea. 

Arsenicum, 3 x, hot, dry skin ; thirst ; red 
tongue ; yellow diarrhoea ; great prostration ; 
face pale and shrunken ; falling of the lower 
jaw; bed sores; picking at the bed clothes; 
distended abdomen ; will restore a patient, 
ofttimes, when considered beyond help. 

Muriatic Acid, 1 x, extreme prostration ; 
patient stupid and unconscious ; sliding 



686 



SPECIAL SYSTEMS. 



down in bed ; low, muttering delirium ; in- 
ability to protrude the tongue ; depression 
of the lower jaw; turning up of the eyes; 
involuntary stool and urine. 

Hyoscyamus, 1 x, violent headache; de- 
lirium ; wild, and tries to uncover himself 
and get out of bed. 

Ulceration of the Boxes. — Silicea, 3 x, 
suppuration following an injury, also Calc. 
Phos.j 3 x. When the ulceration is the 
result of syphilis, give Kali Iod., 1 x. or 
Nitric Acid. Dead bone should be removed, 
and the diseased part washed out with a 
solution of Calendula, one part to eight of 
hot water. A surgeon should have the" care 
of the case. 

Ulcers of the Leg. — Ars., 3 x, Durning 
pain in the ulcer ; low state of the blood. 

Silicea, 30, deep, excavating ulceration; 
varicose veins. Use a wash of Calendula, 
one part to ten of water, and bandage with 
rubber. After they have healed, wear an 
elastic stocking. 

Ulcerated Sore Throat. — Aeon., 1 x, or 
Bell., 3 x, simple sore throat from cold. 

Merc, 3 x, and Kali Bich., 3 x, for in- 
flammation of the follicles of the throat, 
commonly, but very improperly called "diph- 
theritic sore throat." 

Varicose Veins. — Hamamelis, 1 x, in- 
ternally, a good remedy. The extract may 
also be used externally. 

Vomiting. — Ipecac, 1 x, nausea and vom- 
iting ; yellow coated tongue. 

Arsenicum, 30, red tongue; everything is 
vomited as soon as taken ; burning pain in 
stomach ; thirst. 

Antimony Tart., 6 x, vomiting, caused by 
irritation at the base of the brain. 

Verat. Alb., vomiting, attending diarrhoea. 
Small pieces of ice held in the mouth or 
swallowed, will often arrest vomiting. A 
mustard paste over the stomach will help. 

Warts. — Thuja Oc, 3 x, internally, and $ , 
locally. 

Wasting (Emaciation, Atrophy). — Calc. 
Iod., 3 x, where the trouble is with the 
lymphatic system ; scrofulous. 

Calc. Phos., 3 x, children with large heads, 
where the bones have not properly closed. 

Iodine, 3 x, one of the best remedies in 
Atrophy. Cod-liver oil, when without fever, 
the system does not seem to appropriate 
food taken. 

Water Brash. — Nux Vom., 3 x, will 
generally remove the troublesome symptom. 

Watery Eyes. — After opening the lach- 
rymal ducts, give Silicea, 30, twice daily. 

Whites (Leucorrhcea). — This is only a 
symptom of some disease of the womb, and 
can only be cured by giving such remedies 
as will cure the primary trouble. Ars., 3 x, 



will be useful if the discharge causes a burn- 
ing in the vagina, is profuse and watery. '" 

Merc, 3 x, the discharge makes the skin 
sore, is thick and yellow or greenish. 

Kreasotum, 4 x, discharge offensive, of 
any consistency. 

Nux Vom., 3 x, debility; menses too soon; 
constipation, etc. 

Calc. Carb., 30, profuse menses; yellow, 
profuse leucorrhoea. 

Sepia, 30, relaxed mucous membrane ; sick 
and nervous headaches ; delaying menses ; 
chronic uterine troubles. 

Sulphur, cc, useful where any of the other 
remedies seem to be indicated but do not 
help. Calendula solution by injection, also 
Golden Seal. 

Whooping Cough. — Bell., 3 x, flushed 
face, with violent spasm. Ipecac, 1 x, vom- 
iting accompanying the cough. 

Cuprum Acet., 30, violent whooping which 
is constant. 

Corralium Rubrum, 30, will cure many cases 
as though by magic. 

Verat. Vir., 1 x, may be useful if the chest 
becomes congested. Violent attacks of 
whooping cough can be controlled by Kali 
Bromide, Bell, and Castanea Vesica, and 
they should be used under the special direc- 
tion of the physician. 

Worms. — Cina, 30, will remove symptoms 
occasioned by worms. 

Artemisia Vulgaris, 1 x, convulsive and 
nervous irritation caused by worms. 

Yellow Fever. — Camphor <p , violent 
chills, with prostration. 

Aeon., 1 x, fever, burning heat, with quick, 
wiry pulse ; restlessness and great anxiety. 

Bell., 3 x, congestion of the brain; throb- 
bing of the blood vessels in the neck ; red 
face ; red eyes, which are sparkling ; deliri- 
um ; pain in the stomach, with nausea and 
vomiting. 

Bryonia, 3 x, splitting headache; eyes red; 
tongue coated yellow ; parched lips ; great 
irritability and vomiting. 

Argentum N'it., 4 x, dark colored vomiting, 
caused by hemorrhage from the mucous 
membranes of the stomach. 

Arsenicum, 3 x, face yellowish and livid; 
eyes dull and sunken ; lips and tongue 
brown or black ; burning pain in the stomach ; 
suppression of urine ; short, anxious breath- 
ing ; pulse small and tremulous ; cold, 
clammy perspiration ; great prostration and 
black vomiting. 

Hyoscyamus, 1 x, Veratrum Alb., 1 x, 
Crotalus, 30, Cantharides, 3 x, and Ipecac, 
1 x, may also be called for. 

The diet should consist of milk, beef-tea, 
etc., as in typhoid fever. Isolate the patient, 
and use disinfectants freely. 



OSTEOPATHY. 687 

OSTEOPATHY. 

J. W. HOFSESS, M.D., D.O. 

Sometime Dean S. S. Still College of Osteopathy. 

The beginning - of Osteopathy is due to one man, Dr. A. T. Still, 
Kirksville, Mo. This man was a young physician living in Kansas 
during the formative period of that state. His was a great thirst for 
a knowledge of the human body. Many years of original research and 
investigation marked the steps of progress. Proof of the theories which 
he held was made on many sick people before he finally announced his 
discovery to the world in 1874. 

Osteopathy is a method of treating abnormal conditions or disease 
by manipulations. It is the removal of structural malpositions and irri- 
tations, or the stimulating or the inhibiting of functional activities. No 
endeavor will be made to amplify this definition. Some known facts 
are fundamental to the science of Osteopathy. A few will be stated 
and explained. These interpretations will enable the reader to see the 
fitness of the definition. 

How Deviations or Malpositions Cause Disease. — The second 
great basic principle of Osteopathy, and probably the most startling 
to the medical world, is that deviation or malposition of parts is the 
great cause of disease. Health is harmony in the body. Harmony 
cannot be maintained where there is abnormality of structure or mal- 
position of part. Hence, health is present where there is a normal 
position and structure of parts. 

The body is a vital machine — a machine imbued with life. The body, 
being its own laboratory, selects from the food the essentials for repair. 
The body is self-regulative in function. The vital processes are kept 
at work at a certain rate. This power of self-repair and self-regulation 
is often hindered or altered. This will cause disease, or lack of harmony. 
The abnormal position of some part will hinder or alter this power of 
repair and self-regulation of function. 

The most common class of lesions which the osteopath finds, and 
the most far-reaching in their effects, are the ones occurring along the 
spine. A short study of the spine will explain the importance of such 
deviations. There are twenty-four small bones, vertebrae, in the spinal 
column from the head to the sacrum. The sacrum is the wedge between 
the innominate or hip bones. The vertebrae are placed one above the 
other. They are held together by ligaments and muscles. There is a 
small hole through the center of this column of bones. This contains the 
spinal cord and the origin of the thirty-one pairs of spinal nerves. 
Between each two of these bones are little openings called foramina. 



688 SPECIAL SYSTEMS. 

Through these openings the nerves find their way out of the spinal canal, 
and the blood vessels enter in to nourish the structures. The osteopath 
often finds some of these vertebrae twisted or wrenched from their 
normal position. Some deny the truth of this statement. Xo one doubts 
that the elbow may be dislocated, or that some bone in the wrist may 
be wrenched from its normal position. The bones along the spine have 
articulations the same as other joints. They have small, plane surfaces 
for one bone to work, or move, on the other. A vertebra may be moved too 
suddenly, too forcibly, or too far. Its normal position is changed. This 
is a slip, a subluxation, or partial dislocation. A complete dislocation is 
impossible in most parts of the spine without a fracture; but that a slip 
may and does occur is attested by many cases. A person attempts to lift 
a load too heavy for the spinal muscles. A wrench, followed by pain and 
inability to move, is experienced. The person eventually gets rid of the 
pain and moves with comparative ease, yet he is not able to lift the load 
previously lifted. The abnormal position of some vertebra is the cause. 
Correct the abnormality of position and he soon has his former strength. 
Why are such lesions or abnormalities of greater significance than 
others? (i) The irritation or pressure to a greater number of nerve 
fibers. The size of these openings is decreased because of tension on the 
ligaments and muscles, which tension is caused by the spinal deviation. 
Nerves passing through are thus irritated or pressed upon. The tension 
of muscles and ligament increases the condition. (2) Pressure 
and tension on blood vessels. This lessens the amount of blood carried 
to the spinal cord, and a starving of the nerve centers takes place. A 
congestion of the spinal cord may follow if the veins cannot carry the 
blood away. (3) The great distribution and connections of the 
nerves. An injury to the second dorsal or back vertebra may cause 
trouble in the eve, the lungs, the bronchial tubes, or the heart, as well as 
contracture of the muscles of the back. The how and why of this is 
readily seen. The nerves which come from the spinal canal in this region 
send fibers to the muscles of the back, to the eye, to the bronchial tubes 
and lungs, and fibers to the heart. Thus a number of organs may be 
affected by one misplacement or slip. 

The starving of the spinal cord referred to weakens the vitality of 
the nervous system. All parts of the body controlled and supplied by 
these weakened nerves are likewise weakened. Such a condition demands 
the attention of the physician. The cure of such weakness depends upon 
the removal of the spinal condition- 
Other Lesions than Bony Ones. — Bonv lesions are not the only 



OSTEOPATHY. 689 

ones found. Irritation of nerve and muscular contraction are almost as 
common. Tenderness is always an accompaniment of such cases. The 
nerve irritation and muscular contracture may be due to a chilling wind, 
especially if the body has been previously overheated. Overwork and 
sprains are also causes. 

Such irritation and contractures may be a secondary condition. In- 
stance, the eating of food or drinking something that irritates and 
congests the kidneys. The nerves to the kidneys are excited, and the 
impulses started are carried to the center in the spinal cord at the tenth, 
eleventh, and twelfth dorsal, just above the small of the back. Each of 
the three divisions of the spinal nerves receives some of this stimulus or 
irritation from the kidneys. Contracture, rigidity, and tenderness are 
found along the back in the region mentioned, because of this irritation. 

Eating of food that is irritating, or taking too much food, may act 
in like manner on the nerves in the coats of the stomach. Like results 
are found, except that the location is higher up on the back and corre- 
sponds to the origin of nerves to that organ. These are nearly in the 
middle of the back. 

In this short study, sufficient has been said to show that the body 
is a vital machine, self-repairing and self-regulative in function. The 
structure of the part determines the function. Proof was given to show 
that the self-regulative power of the body could be altered or hindered. 
The great cause, distinctly osteopathic, which altered or hindered the 
body power, was some bony lesion. Other factors, such as nerve irrita- 
tion and muscular contracture, may act as causes. Any and all causes 
demand removal in order that harmony may be restored and health 
follow. 

Practical Therapeutics of Osteopathy. — In taking up the practical 
side, the treatment of the disease is the issue. Two questions on treatment 
naturally present themselves : ( 1 ) How does the osteopath discover 
the conditions present, and does this differ from a medical examination? 
(2) How are conditions removed when found? 

A Proper Examination. — In order to discover the condition of the 
body, an examination is necessary. To make a correct examination, it 
is best to remove all tight clothing from the trunk of the body and to 
fully expose the back. A position, sitting on a stool with the head bent 
slightly forward, hands resting on the knees, is really the best. By sight 
and by touch the work must proceed. The condition of the normal curves 
of the spine is noted. 

A definite examination of each vertebra in the back is made by com- 



690 SPECIAL SYSTEMS. 

paring the position of the posterior and lateral processes of each — the 
one with the other. The general flexibility of the back is found by mov- 
ing the patient in different directions — forward, backward, to one side, 
and then to the other, followed by a rotating and turning movement. 
The ease of movement determines the amount of flexibility. Difficulty 
of movement or lessened range shows rigidity. The contracture of the 
muscles is detected by a ropy, band-like feeling on passing the fingers 
over them. Such areas of contracture show that the muscles to this part 
of the back have been irritated directly or reflexly through the nerves. 
The source of the irritation must be located. By such an examination, 
wrong position of the bones of the spinal column is found if present. 

Each rib must be examined. A slip or twist of a rib may cause great 
pain or annoyance. A blood vessel and a nerve run along, the lower 
border of each rib. There is a set of muscles on each side of the nerve 
and the blood vessels. These muscles may contract, irritate the nerve, 
and cause pain. The rib may slip or twist at its junction with the back- 
bone — another cause of pain and tenderness. Such pains sometimes simu- 
late heart trouble and worry the individual greatly. Remove the above 
condition, the patient is freed from pain and soon reports the disappear- 
ance of the so-called heart disease. 

To complete the examination, the patient is placed on a table on the 
back. The position of each bone in the neck and the condition of the 
muscles of that region are closely examined. 

Such an examination is essentially osteopathic and is made only in 
special cases by practitioners of other systems. 

The attention is directed to the internal organs and, if necessary, the 
exact condition of any organ, as lungs, stomach, etc., is supplemented by 
any further investigation needed. 

Thus it is that a diagnosis of the case is made. The prognosis 
depends on the kind of wrong position present and the possibility of its 
removal. The effects on blood vessels and nerves must be taken into 
consideration in making this prognosis. 

How to Remove Conditions Found. — There are generally two 
parts to the treatment of all cases. First, general manipulative measures ; 
second, corrective measures. 

In giving treatments, the machine used by the osteopath is the hand. 
The way is manipulation, and he takes advantage of the many levers in 
the body. You will hear some say he rubs, which he should never do ; 
others that he presses, another that he pulls and twists. He may do all 
of these and more. While this is true, no one must get the idea that the 



OSTEOPATHY. 691 

osteopath does not believe in proper sanitary measures or proper eating 
and drinking. He insists on proper cleanliness of body and surround- 
ings of patient, and may admonish the patient concerning his diet. 

General Manipulative Measures. — In order to understand some of 
the general manipulative movements made, the reader must know that 
the blood supply and the nerve force of the body can be controlled or 
regulated. 

The Nerves of the Body. — How is this great Executive Department 
managed ? ( 1 ) An effect can be produced by steady pressure on a 
nerve; this is called inhibition. Instance, sitting with a leg or arm over 
the edge of a chair or with the legs crossed. In a short time the indi- 
vidual attempts to move the limb; there is no feeling in the part, the 
power to move it is almost if not entirely gone. He feels as if a stick 
of wood were fastened to him. What has happened? The impulses 
along the nerve have been lessened by the steady pressure; and in the 
case cited they were entirely stopped. Thus steady pressure on a nerve 
lessens its activity or completely stops its action. When these impulses 
begin to return, the fact is made known to the individual by prickling 
sensations as if a thousand needles were dancing through the part. 

(2) Another effect on nerves may be produced by vibration or 
by alternate pressure and removal of same. This is called stimulation. 
The doubting Thomas has but to hit his "crazy bone" (ulnar nerve) at 
the bend of the elbow; a strong stimulation follows. There may be 
actual movement of the parts below as shown by twitching and con- 
vulsive motions. The pain seems severe enough to satisfy almost any- 
one that a great stimulation was produced. The effect of such treatment 
is to start nerves to action or to increase present activity. 

It is readily seen that all nerves within reach of the fingers may be 
controlled. What of those not directly accessible to the fingers ? They, 
too, may be regulated. How is this done? 

All nerves are connected with some center. In our study of the 
anatomy of the body it was found that these centers have connection with 
the skin surface by one of their branches. The stimulation or inhibition 
of the skin branches will affect the center. From the center these 
impulses pass out over the many fibers leaving it. Therefore any effect 
on the center affects the nerves connected with that center. These 
effects are to those nerves not accessible to the touch as well as those that 
are. Nerves are injuriously affected in a very marked way by contrac- 
tured muscles. It devolves upon the osteopathic physician to remove the 
sources of this irritation, the contracture. It has been clearly stated how 



692 SPECIAL SYSTEMS. 

these contractures are detected. The removal of such conditions may 
be accomplished in two ways: (1) Steady pressure on the muscle; the 
muscle relaxes and ceases to be a source of irritation. (2) Increase 
the distance between the attachments of the muscle. This is a stretching 
process and relaxation follows. 

The Blood Supply. — The action of the muscles assists in the move- 
ments of this great Transportation System, the blood stream. It has 
just been shown how contractures of muscles are sources of irritation. 
The method of removing such conditions was also explained. Normal 
muscular action will follow. This will give the proper assistance to the 
movement of the blood. 

The Executive Department, the nerves, controls the Transportation 
Department, the blood stream. The methods used to control the nervous 
system have been explained; thus the regulation of the blood stream is 
made doubly sure. 

There are instances where neither the blood stream nor the nerve 
impulses can be regulated by the above treatments. In such cases the 
difficulty is found to consist of bony malposition or displacement. A 
reference will be made to this under the head of corrective measures. 

Specific Manipulation. — The explanation of methods of work on 
muscle, nerve, and other tissue just given is of a very general nature. 
Such treatment is not specific. Specific work consists in the use of any 
one or more of the measures mentioned, in some specific area of the body, 
to produce a specific effect. Instance, the inactivity of the liver and a con- 
sequent constipation. The nerves to the liver are from the middle of the 
back. Any condition detrimental to nerve and blood activity, as contrac- 
tured muscle, slipped vertebrae, or drawn ligaments, must receive special 
attention. The muscle contracture is reduced by steady pressure, or by 
stretching the muscle. The ligaments are stretched by flexion and rota- 
tion. The liver is directly stimulated over the abdomen, just under the 
edge of the ribs on the right side. The bony luxation will be treated 
as given below. 

Corrective Treatment. — In some ways the specific treatment, as 
given, may include or mean corrective treatment. The use of the term 
"corrective" should be limited to the removal of bony lesions, such 
as a slip of a vertebra, twist of a rib, or dislocation of larger joints. 
With this understanding of the word, an explanation of the method of 
procedure will be given. Instance, a young man falls on his head while 
exercising on a turning bar. The force of the fall twists the third bone 
in the neck to the right and slightly backward, The head is thrown to 



OSTEOPATHY. 693 

the left, the chin to the right, and held rigid in this position. The exami- 
nation is made the second day after the fall. The first step toward the 
correction of this lesion is to relax the muscles of the neck as thoroughly 
as possible. It may take several treatments to accomplish this result by 
the methods given above. The bony lesion is then reduced as follows : 
Exaggerate the condition by bending the head further to the left. Follow 
this bending with a straightening of the head, a twisting or turning 
motion being given to the neck at the same time. The length of time and 
the number of treatments required to reduce the difficulty depends on the 
severity of the lesion. Other movements may be used to accomplish the 
same result. The mechanism of the neck is such that one practitioner 
may find some movement of greater value to him than that used by 
another. 

The reader must not infer from the preceding that Osteopathy is a 
system of treatment used only for misplacements and nervous troubles. 
Such conditions, it is true, are readily amenable to osteopathic treatments 
in a large proportion of cases. Many other conditions are equally so. 

Two classes of diseases are worthy of such attention : ( 1 ) Diseases 
of women. (2) Fevers. 

Diseases of Women. — Diseases peculiar to women constitute, as a 
rule, some disturbance of function or structural change in the organs of 
the pelvis. There are two sets of nerves to all these viscera : the cerebro- 
spinal and the sympathetic. Both sets are easily reached by osteopathic 
manipulations. Inhibition or stimulation can readily be given to either 
set. Muscular contractures are as easily removed here as in other parts 
of the body. Direct examination of the parts can be readily made. 
Wrong position and structural changes are easily detected. Replace- 
ment is made if necessary, then such manipulation given as will 
strengthen the ligaments of misplaced organs. The parts will then be 
retained in their normal position. Circulation to the parts here is con- 
trolled in the same manner as that of other parts of the body. Catarrh 
of the parts does not continue after the establishment of a normal circu- 
lation. The control of all abnormal discharges is closely allied with the 
control of the circulation of the part, the seat of the discharge. Much 
of the nerve irritation in this region is due to slips, twists, or wrenches 
to some of the bones of the pelvis. By giving such moves as are necessary 
to overcome these malpositions, nerve irritation and pain are stopped. 
This corrective treatment is absolutely necessary to the proper manage- 
ment of diseases of women. 



694 SPECIAL SYSTEMS. 

Fevers. — The second class to which the attention is called is fevers. 
There is a rise of temperature accompanied by an increase in the pulse 
rate. There is also rapid wasting of tissue, burning up as it were. A 
sluggish or almost suppressed action of the excretory organs (bowels, 
kidneys, and skin) often accompanies such diseases. 

How are such difficulties overcome ? The origin of the nerves to the 
kidneys, as stated, is just above the small of the back. Those to the 
skin are from the neck region to the small of the back. Those to the 
large bowel are from the region of the small of the back. The normal 
action of the liver is necessary to regulate bowel movements. The origin 
of nerves to this viscus is in the region of the eighth, ninth, and tenth 
ribs. This knowledge of the condition of the body and the origin of the 
nerves controlling the different viscera and their functions gives the clue 
to the treatment. Stimulation, inhibition, removing muscular contrac- 
ture, or corrective measures for malpositions, any or all are used. Such 
intelligent work on these different centers is always attended with bene- 
ficial results if the case is a curable one. 

There is quite a rise in the heat of the body in all fevers. Centers 
governing the production of heat and the loss of heat are found in the 
brain. The sympathetic nerves in the region of the neck are closely 
connected with these centers in the brain. These nerves in the neck and 
between the shoulder blades are also closely connected with the center in 
the brain that controls the increase and decrease of size in the blood vessels. 
The treatment in these two areas is of the utmost importance in all cases of 
fever. Through these nerves, and the control of the blood supply of the 
brain, the activity of these centers is regulated. The blood vessels to 
the skin surfaces dilate, more blood passes to these parts, and the heat is 
thrown off, lessening the fever. The severity of the case determines the 
number as well as the frequency of the treatments. 

Space does not permit a full explanation of the methods and effects 
of osteopathic treatment in the above conditions, and forbids the discus- 
sion of many others. Yet it can be safely affirmed that all forms of 
curable diseases and disorders are amenable to osteopathic treatment. 
A word more will be given in support of the above statement : ( i ) 
The blood is regulated by such manipulative measures. (2) The 
nerves of the body are susceptible to mechanical treatment and can be 
regulated thereby. (3) The nerves control all bodily activities, 
including nutrition and elimination. Hence the proper control of these 
forces conduces to harmony in the system, Nature asserts herself, and a 
cure follows. 



RADIOTHERAPY. 695 

RADIOTHERAPY. 

X-Rays in Medicine and Surgery. — An entire volume would not 
suffice to mention by title alone the books and articles that have been 
written in attempts to tell what X-rays are and how their effects are pro- 
duced. The fact that scientists and medical practitioners who make daily 
use of them in experiments and practice do not understand their 
nature fully does not prevent them from taking advantage of the great 
power and benefit that they place at their disposal. Nothing is known of 
the true nature of electricity, yet mankind does not hesitate to employ 
it as a beneficent agency in daily life. 

The plainest statement that can be made about the nature of X-rays 
is that they are a form of electric light rays. They are produced when 
a strong induced electric current passes through a Crookes tube, which 
is a glass tube or bulb from which the air has been exhausted as far as 
possible, and into which wires lead at each end, along which the electric 
current passes. The X-rays can penetrate many substances through or 
into which ordinary light cannot pass. They, however, affect a photo- 
graphic plate in the same way as sunlight, so that it is possible to take 
photographs of the bones and parts of the body hidden by the flesh. They 
do not pass so easily through bone and some other substances as they 
do through clothing and flesh, consequently, the photographs, or skia- 
graphs as they are called, appear like shadow pictures with the flesh as 
the higher lights and the bones and denser substances as the dark 
shadows. 

Risk to Patients in X-Ray Examinations. — In the early days of 
experiment and work with imperfect apparatus in the hands of unskilled 
and inexperienced operators, a few cases of what are known as X-ray 
burns occurred. Reports of these cases were enormously exaggerated in 
a sensational way to which the novelty and the mystery of the force 
added not a little. It is true that if a patient be exposed to the effects of 
the rays for too long a time, or if the current is too high, or if the patient 
is placed too close to the tube, an "X-ray burn" will result. These burns 
are simple surface inflammation of the skin; deeper burns involving the 
tissues under the skin ; or after-effects in the form of ulceration and slow 
healing. There are a few considerations which will satisfy anyone that 
there is in the hands of an expert and skilled user of the apparatus 
absolutely no danger of any of these conditions resulting. 

1. In the first two years, when the apparatus was of the crudest and 
there was no such person as an expert operator known, when every one 



696 SPECIAL SYSTEMS. 

with a smattering of sciences and with the poorest means at hand was 
making exposures under circumstances that would cause a skilled opera- 
tor to-day to shudder, with over twenty millions of exposures made all 
over the world, not more than one hundred cases of burns were known. 
Operators at this time were experimenting to get these very counter- 
irritant effects. 

2. The operator himself is more exposed to the action of the rays than 
the patient is. Especially is this true when he operates on several cases 
a day, while the patients have but one exposure each. 

3. This action is purposely brought about by long exposure in order 
to effect many of the cures of skin diseases, cancer, etc. 

4. With high vacuum tubes, at a distance of not less than twelve 
inches between the tube and the nearest tissues, and an exposure of not 
more than fifteen minutes, a case of burning of even the slightest degree is 
an impossibility. 

5. When the patient is poorly nourished and the surface is heavily 
coated with hair, there is greater possibility of burning in exposures 
that exceed ten minutes. 

6. Long exposures are not to be repeated at intervals of less than a 
week. 

7. Low tubes, those in which the vacuum is not high, and heavy cur- 
rents increase the possibility of injury. 

8. During the Spanish War there were constantly employed seventeen 
machines for the examination of the wounded in the field stations and 
on board ship. There were only two cases of burns reported during the 
entire war. 

To show the extent of popular prejudice against the use of the rays 
for examination, the following is quoted from the experience of Dr. S. H. 
Monell, the eminent Roentgen ray expert :— 

"An intelligent young lady of fifteen with a dislocated shoulder 
exhibited the greatest terror when asked to stand a moment in front of 
the tube for a fluoroscopic examination which would have produced no 
sensation whatever. She declared she knew it would burn her up, and 
would hurt awfully. When the nurse took the position and assured her 
that she felt nothing, the girl allowed a brief examination, but was so 
nervous and alarmed that she was almost in hysterics. It should be the 
duty of every physician, whether he uses X-rays himself or not, to instruct 
his patients for their protection against dread and distrust of them." 

The Fluoroscope. — The taking of photographs, or skiagraphs, for 
purposes of examination causes the delay necessary for the development 
of plates and the printing of the pictures. This is not altogether avoid- 



RADIOTHERAPY. 697 

able, for there are many cases where the photograph must be taken in 
order to make a correct and leisurely diagnosis of the case. But by 
means of the fluoroscope it is possible for the examiner to see directly the 
part or organ that is under examination and to extend this examination 
over large areas. This advantage is well exemplified in the case of a child 
that had swallowed a safety pin. Five days after, it was examined by 
means of the X-rays and the fluoroscope. After unsuccessful examination 
of the oesophagus and the stomach, the pin was found in the intestines. It 
was open, but it was pointing in the right direction. The physician 
refused to operate, on the ground that as it had gone so far in safety 
it would go the rest of the way. It was passed the next day. 

In another case, a boy five years old was suffering from hemorrhages, 
pain in the stomach after eating; was in a highly nervous and emaciated 
condition. Seventeen months previously he had swallowed the key of 
a bookcase. No pain had been felt for twelve months after. The 
fluoroscope showed the key. The boy was given an anaesthetic and the 
forceps introduced into the oesophagus. The fluoroscope showed that the 
forceps were two inches too short to reach the key. By changing the 
boy's position and pressing on the abdomen, the key was reached and 
extracted. It was three inches long, and corroded so much that the 
handle was no thicker than a sheet of paper. Sharp, ragged edges were 
forming through the corrosion. The child would certainly have died 
from starvation, hemorrhage, or inflammation. 

Thus one great value of the fluoroscope, in addition to its value in 
locating a foreign body, is the power of guiding the instruments aright 
without the necessity of making openings into cavities. It also enables 
an operator to proceed at once with an operation, which is often an 
important consideration. 

Foreign Bodies in the CEsophagus. — Another interesting case is 
that of little Beatrice Ward, of London, England. While playing with a 
little toy bicycle, she accidentally swallowed it. Physicians worked in 
the old-time way for four days to remove it. Then she was taken to 
the hospital in a weak and emaciated condition owing to her inability to 
take food. A skiagraph was at once taken and the toy was plainly 
visible in the oesophagus. An operation was at once performed. In 
order not to disfigure the child, a very small opening was made in the 
throat, an instrument was inserted and the bicycle cut in two. In this 
way it was easily removed. The child was unable to swallow and was 
fed by a tube passed into the mouth. At the end of a month she was 
discharged in good health- 



698 



SPECIAL SYSTEMS. 






'•'.:' 




Skiagram Showing the Splintering of one of the Bones 
of the Forearm by a Bullet. Complete and rapid recovery. 



RADIOTHERAPY. 



699 




X-Ray Photograph or Skiagraph of Shattered Femur or Long Bone 
of the Leg. The Patient recovered fully in Two Months, the Progress of 
the Knitting being closely watched through the Splints and Bandages 
by the aid of the fluoroscope. 



700 SPECIAL SYSTEMS. 

Coins are often swallowed by children and, by reason of their lodging 
in the throat sidewise or face upward, it is hard to locate them. By 
causing the child to swallow as far down as possible a little solid food, 
the point at which it stops is easily located by the fluoroscope or by means 
of a skiagraph. 

Foreign Bodies in the Eyeball. — Mechanics and other metal 
workers often suffer from the lodgment of pieces of sharp metal in 
the eyeball. The great value of the X-rays is not only in locating them, 
but the shortest road to them is pointed out so that there is the least pos- 
sible injury resulting from the operation. 

Examination of the Brain. — Tumors and abscesses of the brain are 
always extremely difficult to diagnose, and their location by ordinary 
means is almost an impossibility, at least with certainty. These are com- 
ing more and more in the reach of the expert by reason of great improve- 
ments in apparatus and the greater experience in reading skiagraphs. 

Bullet wounds in the head have always presented great difficulty on 
account of the difficulty of probing for the ball. The location of such 
is now an easy matter, and the possibility of relief from an operation is 
clearly determined. 

X-Rays in Dentistry. — The profession was very quick to realize the 
great assistance that it would derive from the use of skiagraphy in their 
work. Among its uses may be mentioned the certain knowledge about 
teeth which have not yet erupted. Where the full complement of teeth 
have not appeared at an age when they are all to be in place, a dentist 
can tell at once whether there is a tooth in the alveolus or not. Hence 
he will be able to decide accurately upon the advisability or necessity 
of supplying one. In extraction of the molars when impacted, it is of the 
greatest assistance to know in what direction the roots of the tooth run. 
Ignorance on this point is the cause of the breaking of teeth in extract- 
ing. The presence and extent of an abscess are clearly demonstrated by 
a skiagraph and by it alone. Abnormal formation of the roots of 
teeth is at once made clear. The presence of a portion of an instrument 
accidentally broken in the canal and whether or not the extremity of it pro- 
jects beyond the apex, a fact of the utmost importance, are made equally 
certain. The dentist is able to examine the root of a badly formed tooth 
and to at once decide upon the possibility of attaching a crown to it; 
he thus knows beforehand the prospects of success attending the opera- 
tion. He can locate broken roots in the sockets and tell their size, posi- 
tion, and shape, as well as decide upon the best means of removing them. 
In cases of injury to the teeth and mouth from blows, he can tell whether 



RADIOTHERAPY. 701 

the root of a tooth or the process is injured or broken. These are a few 
of the uses to which the X-rays are now put in dental surgery. 

Detection of Incipient Consumption. — This calls for keenness of 
perception that only long practice can give. The power to distinguish 
between the shadows cast by flesh and those of bone is an easy matter; 
but when it is necessary to tell what shadows are cast by water, as in 
pleurisy, or of pus, as in emphysema, or by blood is all a matter of eye- 
training secured by wide experience. The early deposits of the tubercle 
in the lungs are hard to detect. When the lungs are healthy, they are 
translucent so far as the X-rays are concerned; the matter deposited by 
the tubercle casts a very faint shadow at first, not appreciable by any but 
a skilled operator. Where a great number of cases pass through an 
expert's hands and a record of the cases is kept, he in time comes to 
perceive the changes which the subsequent history of the case confirms 
or contradicts. It is unnecessary to go into the technic of the manner of 
detection, but it is sufficient to say that the X-rays can detect consumption 
earlier than the stethoscope can, and can also record the ravages of the 
disease and note any improvement in the case. 

Detection of Aneurism. — It is a matter of record that the X-rays 
can demonstrate the existence of aneurism before there are any physical 
signs of the disease. In other affections of the heart, it is possible to 
observe the heart's action and to observe the irregularities of a diseased 
condition. 

Detection of Stone in the Kidney, Renal Calculi. — Not only is the 
detection possible, but accurate location can be made with the greatest 
nicety. Very recently, stones were recognized and located in a case, and 
immediate operation was decided upon. Incision was made and the 
affected kidney was drawn through the opening. The stones were cut 
down on and removed. The patient made a good recovery. 

Stone in the Bladder. — The detection of stone in the bladder by 
ordinary means is usually quite easy; but there are cases when the 
method is painful, and, in a few, such as those in which mechanical 
difficulties exist, the ordinary means are impossible. In all cases, the 
X-ray method is not only satisfactory in point of time, ease, and com- 
fort to the patient, but in certainty even in encysted and multiple calculus. 

Examination of Fractures. — In no part of medicine or surgery are 
the results of an X-ray examination so satisfactory as in the examination 
of fractures. Of all the tissues of the body, bone offers the greatest 
resistance to the action of the rays and, consequently, casts the greatest 
and most distinctly marked shadow and contrast. To the untrained 



;o2 SPECIAL SYSTEMS. 

eye a skiagraph of a fractured bone is clean and very easily read. One 
of the ordinary means of diagnosing a fracture is by rubbing the broken 
surfaces of the bone together and thus producing a sound known as 
crepitation, which is perceived by the combined senses of touch and 
hearing. When there is much swelling of the part, or when the bone is 
in an obscure part of the body, this is very hard to detect. When the bone 
is cracked or splintered, diagnosis by this means is often impossible. It 
is often extremely difficult to distinguish between a sprain, a fracture, 
and a dislocation. An examination by ordinary means is often attended 
with great suffering on the part of the patient. But with an X-ray 
examination, either by the fluoroscope or the skiagraph, all of this is 
changed. The bone and its condition is revealed to the surgeon's eye 
as clearly and distinctly as if it were laid open before him. Not only that, 
but he is able to tell when the parts are properly adjusted, and when 
the fracture or dislocation is properly reduced. Then as the bandages, 
splints, and casts offer no resistance to the penetration of the rays, he 
is able to examine the part every week, if necessary, and to watch the 
union of the bony parts, so that deformity from imperfect setting is 
impossible. If the bones are not properly adjusted, or if union between 
the ends of the bone does not take place in the right way, a deformity 
exists, and it is necessary to break the limb again and correct the deform- 
ity. This is impossible when X-ray examination is used. So great has 
been the revelation of slight fractures in cases of supposed sprains, that 
there is now no doubt that in the past, without the service of the X-rays, 
a great many small fractures have been overlooked. 

Location of Foreign Bodies. — X-ray examination has proved 
invaluable in location of bullets, needles, pins, and pieces of glass, which, 
after entrance into parts of the body, travel considerable distances, not 
only in their first flight, but are moved onward in all directions by the 
working of the muscles. 

The danger of infection from using a probe in the search for a bullet 
is very great. As it is pushed along the track of the ball, it carries into 
the wound much of the poisonous, infectious matter which has lodged in 
the wound, so that, no matter what antiseptic means are adopted, there is 
always danger of blood poisoning. In the majority of cases, the probe 
fails, so that the method of examination ordinarily adopted cannot 
be said to be successful. X-ray examination has proved to be of wonder- 
ful assistance in the Spanish War and in the war in South Africa. It 
is the opinion of military surgeons that the day of the probe and the 
electric probe has gone by. The bullet is easily and accurately located 



ANTITOXIN. 703 

and the surgeon cuts down upon it by the shortest path, leaving the path 
of the bullet to heal up without further laceration or with danger from in- 
fection. 

The distances that needles travel through the tissues of the body, 
often without causing much pain until they reach certain points 
in the body, is really wonderful. So much is this the case that the point 
of entrance of a needle into the flesh is often of little value to the sur- 
geon in locating it after a time. The X-rays locate them quickly and 
accurately, so that their removal is a comparatively easy matter. In 
fact, in all surgical cases of the sort, exploration with all its painful and 
unsatisfactory results is done away with. 

Measurement and Examination of the Pelvis. — The measurement 
of the pelvis and examination for deformity are of the greatest value in 
cases of prospective childbirth. It is not in the slightest degree accom- 
panied by any injurious results to either mother or child. 

Curvature of the Spine. — As the spinal column is of great length, it 
is not possible to record upon a skiagraph a very comprehensive section 
of the vertebra on one exposure. It takes, perhaps, four or five to dis- 
play the entire column. But the clearness with which even slight 
irregularities of form are recorded is of the greatest assistance in the 
treatment of this form of disease. It is valuable in indicating the prog- 
ress of the disease under treatment. 

Orthopaedic Surgery. — The exact condition of the joints in all cases 
of deformity and enlargement resulting from gout, rheumatism, tuber- 
culosis, or whatever cause, is distinctly shown by the X-rays. 

ANTITOXIN IN DIPHTHERIA AND THE USE OF OTHER 

SERUM. 

Antitoxin is a substance which counteracts the poison of disease. It is 
derived from the serum of the blood of an animal which has been inocu- 
lated by the poison of that disease, and in this way rendered immune 
against it. The antitoxin of diphtheria is derived usually from the body 
of a horse which has been inoculated or vaccinated with the poison of 
diphtheria for a period of three months. It is transparent and of a yel- 
lowish or reddish color. It is important that antitoxin be always of the 
same strength. This is secured by a process known as standardizing the 
solution. One unit of stardardized antitoxin is a sufficient quantity to neu- 
tralize one hundred times that quantity of the poison of diphtheria, which 
is just fatal to a guinea pig of two hundred fifty grams weight. The dose 
of diphtheria antitoxin standardized in this way is fifteen cubic centi- 



704 SPECIAL SYSTEMS. 

meters. This is injected into the body of the patient under the skin when 
the disease is suspected or before the diagnosis is absolute. At the end 
of twelve hours, another dose of ten cubic centimeters is injected in the 
same way. This is the treatment adopted in the case of children. Adults 
require larger doses. If the case is very serious, the dose is increased. 
Twenty-five cubic centimeters are often given as the first dose and 
twenty-five more during the first twenty-four hours; it is not at all 
unusual for a dose of one hundred cubic centimeters to be given during 
the first few days. The portion of the abdomen where the injection 
is made is first washed with a four per cent solution of carbonic acid 
or a one per cent solution of lysol. It is customary in families where 
a case of diphtheria is suspected to administer small doses to the other 
members of the family, in order to render them immume against the 
disease. The injections are almost painless. Immediately after the 
administration, a swelling occurs under the skin, but it soon disappears 
with the absorption of the fluid. Antiseptic methods are adopted in the 
cleansing of the syringe, both before and after the dose is administered. 
No immediate results are observable from the antitoxin. Within twenty- 
four hours, however, the temperature of the patient will be observed to 
rise only one to two degrees. The pulse of a child may be from one 
hundred twenty to one hundred thirty beats per minute. This reaction 
is likely to be more noticeable in the case of children to whom the dose 
is given as a preventive than will be the case of those suffering from 
the disease. If the case is a very mild one, a favorable effect may be 
noticed within twelve hours; in very serious cases, it may be thirty-six 
hours before an improvement is noticed. The essential point of the ad- 
ministration of antitoxin is that it be given in time, and it is not wise to 
wait until a diagnosis is confirmed or until the disease is fully developed. 
In all cases where diphtheria is suspected, it is most prudent to resort at 
once to the preventive measures. The first favorable appearance after 
the injection of antitoxin is the change in color of the false membrane 
which forms in the throat; the change is usually from gray to white. 
Very soon after this change in color, the membranes become detached 
or expelled and usually do not reappear. Caution must be used about the 
time the membranes fall, for they may sink back into the throat and 
obstruct the breathing. 

The change in respiration will be an indication of this, and in some 
cases tracheotomy may be necessary to prevent suffocation. Statistics 
from hospitals show that the death rate of diphtheria has been decreased 
from fifty and sixty per cent to twelve per cent by the use of antitoxin 



VACCINATION. 705 

It must be remembered that serum must be given early in the disease 
to secure the best results. After the third day of illness, the value of 
serum diminishes very rapidly, for the poison of the disease has made 
such headway that is is impossible then for the serum to neutralize it. 

After the administration of serum, a redness or rash may be observed 
over the skin of the body; but this occurs in only very few cases, and 
lasts for only a short time. In a very few cases, sudden death has 
followed the injection of serum; in those cases it is not at all clear 
that it was the serum that caused death. On the other hand, there is 
abundant testimony to prove that the serum itself is absolutely harmless. 

Antitoxin in Tetanus or Lockjaw. — The value of this serum has 
been abundantly demonstrated, not only by experiments upon animals, 
but in quite a large number of cases of lockjaw in adults produced by 
wounds. The great difficulty with which one has to contend in these 
cases is the rapid absorption of lockjaw poisoning into the system. 

VACCINATION. 

The reaction which follows inoculation with the virus of cowpox is 
known as vaccinia. This furnishes protection and almost certain 
immunity from smallpox. When, however, smallpox is taken by one who 
has been vaccinated, the disease is extremely mild and is known as 
varioloid. 

All authorities agree that vaccination should be performed in infancy, 
and again at puberty. When smallpox is prevalent, it is a safe rule to 
vaccinate all who have not been successfully vaccinated within five 
years. 

Mode of Vaccination. — The area chosen is to be thoroughly cleansed 
with soap and water, and, finally, with alcohol. The instrument used 
to scratch or scarify the skin should be thoroughly sterilized by dipping 
it in boiling water, or other antiseptic fluid. The scratched surface of 
the skin should not bleed, but merely allow a pinkish serum to ooze out. 
The virus is then applied. The quality and purity of the virus should be 
unquestionable. Protection is necessary while the wound is progressing, 
to prevent the clothing from touching it. The best protection for infants 
is afforded by a sterilized bandage sewed to the inner clothing. Older 
children may have a pad of sterilized gauze, held in place over the wound 
by strips of adhesive plaster. If there is a discharge of matter, the 
wound is to be kept clean and dried by means of a daily dusting with 
powdered boric acid. Poultices and similar applications are dangerous. 
After vaccination, the limb should not be washed for twenty-four hours. 



;o6 SPECIAL SYSTEMS. 

Successful vaccination is followed by a pimple on the third day; a 
vesicle forms on the sixth, and a pustule, with a reddish rim, on the 
eighth. A crust forms over the pustule on the fourteenth day and falls 
off on the twenty-third. 

It is not unusual for vaccination to be followed by eruptions and 
rashes of greater or less severity. Care in the selection and administra- 
tion of the virus will greatly reduce them. The number of deaths 
resulting from vaccination is so small that they may be disregarded. In 
fact, all such are preventable by care. German records, faithfully kept, 
show only thirty-five deaths out of 2,275,000 cases. 

HYDROTHERAPY. 

There is a fine distinction made between Hydrotherapy and Hydrop- 
athy. The former is taken to mean the use of water in the treatment 
of disease as an aid or an adjunct to other medical treatment ; hydropathy 
is to be regarded as a sole means of treating disease. 

Whatever point of view may be entertained, there is no doubt of 
the very great value of water in the treatment of disease. Every one 
appreciates the value of hot and cold baths, of douches, of the hot 
and cold pack, administered by wrapping wet sheets around the body, 
and of the copious use of water internally. 

These have been fully dealt with in the sections on "Personal 
Hygiene" and "Nursing." 

In the animal economy, water plays an important part. In our food 
we consume large quantities of water, as it forms from eighty per cent 
to ninety per cent of a meal. Its great necessity is to aid in the elimina- 
tion of poisonous and waste matter from the system. In this way, water 
not only accelerates waste, but aids in the construction of the same por- 
tion of the body. So we are obliged to recognize water as an important 
alterative. 

In the form of a hot bath, water is an excellent stimulant, and fre- 
quently it increases the circulation from seventy to one hundred pulse 
beats or over, within fifteen minutes. 

Of the emetics, warm water is to be considered one of the best. Its 
efficiency is much increased by the addition of a small quantity of 
mustard. 

As a sedative, cold water in the form of a bath will lower the tem- 
perature, rapidly diminish the pulse, and reduce excessively high vital 
processes. This has been described fully in the article on "Nursing," 
where details of Brand's baths and their usefulness in typhoid fever, are 
given. 



HYDROTHERAPY. 707 

As an anodyne, water in the form of hot or cold applications is 
extremely useful and the effects are quite familiar. In the form of ice 
or freezing applications, water is a useful local anaesthetic. By the 
alternation of hot and cold applications, chronic swellings of the joints 
and enlargements of glands are successfully treated and reduced. 

It is probably in the direction of medicated waters, either natural or 
artificial, that the value of water as a curative agent is best known. 

Alkaline waters owe their value to the fact that they contain the 
carbonate and bicarbonate of soda; other salts are present also in small 
quantities. The alkaline taste is disagreeable to many persons, but this 
is overcome by charging the waters with carbonic acid gas, which, while 
it does not affect their curative values, very greatly improves their taste. 
They are especially valuable, and produce their best effects, in chronic 
catarrh of the several parts of the body; nephritis, or inflamma- 
tion of the kidneys ; diabetes ; acute and chronic inflammation of the 
bladder; gout; and chronic rheumatism. These are among the most 
common diseases to which man is subject. 

Carbonic acid waters are recognizable by their bright, sparkling 
appearance, and are most valuable in cases of fever, in the relief of 
nausea, and the prevention of vomiting. Given in milk in cases of 
irritable stomach, they not only exert in themselves a beneficial effect, 
but also improve the taste of the milk. 

Iron waters contain iron salts and are known as chalybeate waters. 
They are especially valuable in anaemia, scrofula, and poverty of the 
blood. 

Saline waters contain common salt and other ingredients. They are 
valuable in the promotion of digestion and the assimilation of food, but, 
in large doses, they act as an emetic and purgative. Not more than from 
one to five drams of salt should be taken in twenty-four hours. In inflam- 
mation of the stomach and dyspepsia, they are often of benefit if taken 
hot before breakfast. The most palatable form of these waters is that 
naturally charged with carbonic acid gas. 

Calcareous waters contain the salts of lime and are easily recogniz- 
able by their hard qualities. They are beneficial in rickets in children, 
inflammation of the bladder, and diabetes; but the important objection to 
their use is their interference with digestion. 

Sulphur waters contain a solution of hydrogen sulphide acid. They 
are usually disagreeable in taste. They stimulate secretions and induce 
perspiration. In addition to their internal use, they are of great value 
as baths, especially in cases of chronic affections of the skin ; rheumatism 



708 SPECIAL SYSTEMS. 

and gout; neuralgia; paralysis; enlarged joints with contracted muscles 
or tendons are also much benefited by their use. 



Hunyadi Janos Water. 

Sulphate of Lime, i 1 /, ounces. 

Glauber Salts, 24 ounces. 

Epsom Salts, 26 ounces. 

Sulphate of Potassa, 1 dram. 

Pure Spring Water, 10 gallons. 



Vichy Water. 

Carbonate of Ammonia, 10 grains. 

Bicarbonate of Soda, 5^2 ounces. 

Common Salt, 6 drams. 

Phosphate of Soda, 25 grains. 

Sulphate of Soda, 4 scruples. 

Sulphate of Potassa, 2 drams. 

Pure Spring Water, 10 gallons. 



Congress Water. 

Calcined Magnesia, 1 ounce. 

Bicarbonate of Soda, 20 grains. 

Hydrate of Soda, 23 grains. 

Common Salt, 7 J4 ounces. 

Pure Spring Water, 10 gallons. 



Carlsbad Water. 

Sulphate of Soda, 100 grains. 

Carbonate of Soda, 25 grains. 

Sulphate of Magnesia, 15 grains. 

Chloride of Sodium, 16 grains. 

Chloride of Calcium, 15 grains. 

Tartrate of Iron and Potassa, 10 grains. 

Pure Spring Water, 10 gallons. 



Seltzer Water. 

Bicarbonate of Soda, 55^ ounces. 

Carbonate of Magnesia. 7 drams. 

Marble Dust, ' . . y 2 ounce. 

Muriatic Acid (C. P.), sH ounces. 

Pure Spring Water, 10 gallons. 



ELECTROTHERAPY. 709 

Kissingen Waters. 

Bicarbonate of Soda, 1 dram. 

Carbonate of Lime, 2 drams and 2 scruples. 

Precipitate Carbonate of Iron, 2 scruples. 

Phosphate of Lime, 2 drams and 2 scruples. 

Phosphate of Soda, 13 grains. 

Sulphate of Magnesia, 2 ounces. 

Sulphate of Soda, 2 drams and two scruples. 

Muriate of Ammonia, 4 grains. 

Common Salt 8 ounces. 

Pure Spring Water, 10 gallons. 



ELECTROTHERAPY. 

It is in cases of nervous affection that electric treatment is most 
beneficial. 

Galvanism or galvanic electricity is that form which is generated by 
chemical action. It is also known as voltaic electricity. The current is 
either constant or may be interrupted by artificial means, and, according 
to the mode of interruption, is known as slowly or rapidly interrupted. 
Galvanism produces a sensation of prickling and heat attended by redness. 
When applied in sufficient intensity and for a long period, inflammation 
and even sloughing of the parts will follow. Among the uses of galvanic 
electricity in therapeutics are : — 

1. Experience of the nerves and skin. 

2. Destruction of the outer skin or of tissues, as in electro-cautery or 
burning. 

3. Application of heat to a part, as in electrical heaters. 

4. To restore power to a paralyzed muscle. 

5. To increase the contractile power of a muscle. 

Faradism is the use of induction currents in the treatment of disease. 
It is a more powerful stimulant and excitant than is galvanism. The 
current passes through a wire and, without contact, excites a current in 
a second wire placed parallel to it. 

Multiple Neuritis. — This responds best to electrical treatment. Use 
the rapidly interrupted faradic current when there is loss of sensation 
and of power ; but not when there are signs of pain or of extreme sensi- 
tiveness. Muscles which are affected by loss of power may be exercised 
by the slowly interrupted faradic current, but not to the point of exhaus- 
tion. 



7 io SPECIAL SYSTEMS. 

Facial Paralysis. — Electrical treatment is of little value, as the mus- 
cles would be fatigued before sufficient trophic impulse could reach them. 

Paralysis Agitans or Shaking Palsy. — As a rule, electrical treat- 
ment is of no benefit. 

Hysteria. — Where there is local loss of sensation, the rapidly inter- 
rupted faradic current is of benefit when applied by the wet sponge, or, 
in severe cases, by the dry wire brush. The dry electric brush is often of 
great benefit by reason of the mental impression made upon the patient. 

Neurasthenia or Nervous Prostration. — The slowly interrupted 
faradic current every day; one treatment without exhaustion is bene- 
ficial, especially if alternated with massage. This gives the necessary 
exercise without fatigue. The general application of the rapidly inter- 
rupted current, not to exceed fifteen minutes' duration, is also helpful. 

Locomotor Ataxia. — Electricity, in the form of the galvanic current, 
is of benefit in some cases. The positive pole is placed on the neck and 
the negative pole over the sacrum and, again, at the soles of the feet. 
Large electrodes are of benefit, as by their use the current is made to 
influence an extensive area. The effect of this is purely sedative. 

Infantile Spinal Paralysis. — The slowly interrupted faradic current 
is applied to the paralyzed muscles and especially to those only partly 
paralyzed. The effect is stimulation of their nutrition and the preven- 
tion of atrophy. If too strong a current is used, or if the period of applica- 
tion is long enough to produce fatigue, atrophy of the parts is hastened. 
All inflammation must have subsided from the spinal cord before elec- 
tricity is used or it will produce serious results. The child must not suffer 
in the least from the strength of the current. 

Neuritis. — Faradic electricity of moderate strength may be used over 
the area supplied by the affected nerve. This has the effect of restoring 
sensation to the part and, by the faradic contractility of the muscle, to 
bring back the lost motor power. Once a day, and then for only a few 
minutes, is sufficient treatment. If exhaustion follows, the treatment 
should be discontinued. 

PHOTOTHERAPY. 

Phototherapy is the treatment of disease by exposure to light. 
Ordinary white sunlight or electric light may easily be broken up by 
means of a glass prism into the spectrum composed of the seven con- 
stituent colors : violet, indigo, blue, green, yellow, orange, and red. Sun- 
shine is undoubtedly a disinfectant and a germ killer. The uses of light 
and its chemical effects in photography are familiar to every one. The 



PHOTOTHERAPY. 711 

sunburn and tan resulting from exposure to the sun is a chemical effect 
of the light of the sun, and not a result of the heat. The chemical rays 
of the sun, or of all white light, are those which produce these and other 
chemical effects, and are the violet, ultra-violet, and the blue rays. That 
red has no chemical action is abundantly proven by the use of the ruby 
light in the dark room by photographers while developing the most 
rapid plates. 

White light is of little use as a curative or therapeutical agent because 
its action is so slow. When the rays are focused by means of the 
familiar burning glass, the action is intensified. But the best results come 
from the use of the violet, ultra-violet, and blue rays, which produce the 
chemical effects. The treatment and methods are referred to as the 
Finsen light, from the name of the doctor in Norway who has perfected 
the system. In its simplest form, the apparatus consists of an eight-inch 
flat brass ring, to which is fitted on one side a curved glass and on the 
other a flat glass with a space between filled with a weak ammoniacal 
solution of copper sulphate, which is of a bright blue color. As the 
rays of white light pass through this convex lens, the liquid absorbs 
most of the ultra-red, red, and yellow rays, by which most of the heat 
is conveyed, and so the light is cooled. The dosage is controlled by the 
intensity of the light, the size of the lens, the distance from the patient, 
and the length of time to which the patient is subjected to exposure. 

Sunlight is the best source of light, but arc lights are most convenient. 
Incandescent will not do, as they are of low power and are shielded by 
white glass, which interferes with the efficiency. This interference was 
accidentally proven by the 308,000 candle power arc light at Niagara Falls, 
used in electric drilling ; the highest power electric light known. Work- 
men exposed to the action of this powerful light for only a few minutes 
suffered intensely from pain in the eyes. But plain white spectacles 
afforded absolute protection against its effects. 

Only the part of the body to be treated is exposed to the light. The 
ordinary sitting is one hour a day. In cases of lupus and similar growth, 
the treatment may extend over months or even a year. But the results 
which have been secured, not only in the direction of a positive cure, but in 
the healing with slight disfigurement, abundantly reward the patience of 
both sufferer and operator. Besides, the painless nature of the treatment 
is vastly preferable to the use of the knife. Some of the quickest results 
have been obtained, however, by the combination of a surgical operation 
and subsequent Finsen light treatment. 

Among the diseases which have been reported upon most encourag- 



712 SPECIAL SYSTEMS. 

ingly as yielding to the Finsen treatment are : lupus, rodent or eating ulcer, 
tuberculosis, numerous skin diseases, stiffness of the joints, rheumatism, 
asthma, bronchitis, and sciatica. 

A system of baths, hot and cold pack, massage, and Swedish move- 
ments are operated successfully in conjunction with phototherapy. 

HYPNOTISM IN SURGERY. 

The word "hypnotism" dates only from the middle of the nineteenth 
century, when James Braid, a British surgeon, coined the name "neuro- 
hypnotism" for certain psychic phenomena which had been receiving 
great attention for half a century. Neurohypnotism means nerve-sleep, 
and was soon shortened to hypnotism. 

The thing itself is almost as old as the human race. Under various 
forms and names, and more or less mixed with charlatanry, it was the 
stock in trade of the magicians of ancient Egypt and Chaldea, of Hindu 
ascetics, and of medicine men of savage tribes. Modern hypnotism made 
its debut under the name of mesmerism in 1778. In that year a German, 
Dr. Mesmer, began to astonish Paris with his hypnotic therapeutics. 

Dr. Braid Took It up in England, practicing it successfully, and 
writing several books on the subject. During the latter part of the nine- 
teenth century there was quite a revival of interest, due largely to the 
investigations and experiments of French physicians. They divided into 
two "schools" of hypnotism under the leadership of Charcot in Paris and 
of Bernheim at Nancy. Both accomplished wonderful results, but dif- 
fered mainly in their theories of the nature of hypnosis; the .first faction 
regarding it as a diseased condition, the second as normal. But together 
they succeeded in raising such a cloud of discussion and uncertainty about 
the whole subject as to bring it into discredit with strictly scientific men, 
and there it remains to-day. 

As a Natural and Unfortunate Result, an abounding richness of 
misinformation is current among the laity in regard to hypnotism, 
especially in surgery. This has been helped along materially by 
ignorant and unscrupulous persons for their own purposes. It has been 
stated, both orally and in print, and is currently believed, that under 
hypnosis teeth are frequently extracted, and even legs and arms cut 
off. Little, if any, of this is true. 

Why Not? — In the first place, it is too risky. Hypnosis, so complete 
as to permit of safe and painless surgery, would need to pass into the 
third stage, and sometimes patients cannot be brought back from the 



HYPNOTISM IN SURGERY. 713 

depths of the third stage. Again, it js unsatisfactory. Either the 
sleep is not deep enough, or it is so deep as to be dangerous, for 
patients differ greatly in susceptibility. Furthermore, the general opinion 
among physicians is that the complete surrender of the will requisite 
for hypnotism is not beneficial to the patient's personality. When local 
anaesthesia may be obtained so satisfactorily by means of cocaine or 
freezing, and general anaesthesia by ether, chloroform, nitrous oxide, or 
scopolamine, surgeons do not care to spend time or take chances with 
hypnotism. 

Suggestion, either with or without hypnotism, is credited by many 
people with miraculous curative powers, extending even to surgery. 
Such extremists will often go so far as to claim that it can cause dis- 
located bones to fly back into their sockets, broken bones to knit, and 
hemorrhages to cease beyond the ordinary phenomena of Nature. Of 
course these are merely examples of the well-known and fully recognized 
influence of the mind over the body, distorted and exaggerated to fit a 
theory. Every intelligent person knows, from both observation and per- 
sonal experience, that the state of mind has much to do with bodily func- 
tions and conditions, and vice versa; but that does not justify trying to 
substitute hypnotism for surgery. The true therapeutic use of hypnosis 
and suggestion lies, therefore, in that range of palliative influences of 
which the mind is known to be capable. But it cannot properly be 
classed as a curative agent, in the sense that it directly causes the expul- 
sion or death of disease germs, or the reduction of dislocated bones. 




Head. 



Cervical vertebrae. 

Clavicle. 
Glenoid fossa. 



Humerus. 



Ilium. 
Ulna. 
Radius. 
Acetabulum. 



Carpus. 
Metacarpus. 

Phalanges. 
Femur. 



Patella. 



Tibia. 
Fibula. 



Tarsus. 

Metatarsus. 

Phalanges. 



Fig. 137. Human Skeleton. 



BOOK X. 

ANATOMY AND PHYSIOLOGY. 

CHARLES H. CLEMMER, M.A. 
State Institute Conductor of Teachers' Institutes. 

Anatomy treats of the structure and organization of living beings. 
Comparative anatomy compares the structure of different kinds and 
classes of animals. Histology is microscopic anatomy. 

Physiology deals with the uses, or functions, of the different parts 
of living beings, and the manner of their working. 

Hygiene treats of the conditions of life which promote health. 

Protoplasm, the so-called physical basis of life, is a mixture of spongi- 
oplasm and hyaloplasm, which constitutes the main bulk of the bodies 
of most cells. It possesses vital properties whereby the processes of 
nutrition, secretion, and growth go forward; such as contractility, irri- 
tability, metabolism, reproduction. 

Tissues are the primary building material that enters into the con- 
struction of the body. They are made up of cells. 

Cells, when fully formed, consist of (i) a cell body (protoplasm) ; 
(2) a cell nucleus, which is less granular than the cell body and embedded 
in it; (3) the nucleolus, a tiny dot lying in the nucleus. These cells are 
very small and are seldom more than one-thousandth of an inch in 
diameter. They differ in shape. As a rule, they are either rounded 
and thick, as those which float in the blood; flattened and thin, as those 
of the membranes ; or elongated to form slender threads, known as fibers. 
Long fibers are often made up of elongated cells, joined end to end. The 
life of the cells is very brief. They are reproduced by dividing them- 
selves into two parts, each half soon forming a new cell exactly like the 
old one from which it sprang. The process by which living cells are 
nourished by the nutritive material of the blood, or that by which they 
transform their cell protoplasm into other substances, is known as 
metabolism; hence it may be either constructive or destructive. 

An organ is a distinct portion of the body capable of performing 
some special action (function), as the liver, the heart. 

A system consists of several different organs, of similar structure, 
spread throughout the body, and performing similar functions, as the 
nervous system. 

An apparatus is a number of organs which work together to accom- 
plish a particular object, as the digestive apparatus. 

A function is the work done by a healthy organ in the body, as the 
function of the liver in the secretion of bile. 



716 



ANATOMY AND PHYSIOLOGY. 




A, Frontal bone. B, Parietal bone. C, Occip- 
ital bone. D, Temporal bone. E, Large wing of 
sphenoid bone. F, Lambdoid suture. G, Occip- 
ito-parietal suture. H, Squamoparietal suture. 
I, Mastoparietal suture. J, Sphenoparietal su- 
ture. K, Sphenotemporal suture. L, Spheno- 
frontal suture. M, Temporal ridge. N, Malar or 
cheek bone. O, Frontomalar suture. P, Malo- 
temporal suture. Q, Malomaxillary suture. R, 
Superior maxillary bone. S, Infraorbital fo- 
ramen. T, Nasal bone. U, Nasomaxillary suture. 
V, Nasofrontal suture. W, Lachrymal groove. 
X, Nasal eminence. Y, Inferior maxillary bone. 
Z. Mental Foramen, i, Angle of lower jaw or 
Ramus. 2, Coronoid process. 3, Condyle. 4, 
Neck of condyle. 5, External auditory canal. 6, 
Styloid process 7, Mastoid process. 8, Masto- 
occipital suture. 



Fig, 138. The Skull. 




Fig. 139. Base of the Skull. 



1, Suture of the palatine vault or roof of the mouth. 2, Anterior palatine canal. 3, Posterior 
palatine canal. 4, Posterior nasal spine. 5, Posterior border of nasal septum. 6, Process of 
sphenoid bone. 7, Internal pterygoid (wing-shaped) plate. 8, External pterygoid plate. 9, 
Scaphoid fossa. 10, Oval foramen. 11, Spinous foramen. 12, Foramen lacerum medium. 13, 
Zygomatic arch. 14, Union of the sphenoid and occipital bones. 15, Glenoid cavity into which the 
lower jaw bone fits. 16, External auditory canal. 17, Mastoid process ; large eminence behind the 
ear. 18, Styloid process. 19, Lower opening of the carotid canal. 20, Foramen lacerum posterius. 
21, Occipital condyles which rest on the articular surfaces of the axis. 22, Basilar process. 23, 
Foramen magnum, through which the medulla oblongata or spinal cord passes. 24, External 
occipital crest. 25, Inferior curved lines of occipital bones to which muscles are attached. 



THE HUMAN BODY. 717 

STRUCTURE OF THE BODY. 

The human body is composed of solids and fluids. The fluids are 
most abundant in children and youth. It is this which gives softness 
and pliancy to their flesh. In old age, the fluids are less abundant, and 
the flesh is more hard and wrinkled. The fluids contain the whole body, 
as it were, in a state of solution; or rather, they hold the materials out 
of which it is manufactured. 

CHEMICAL PROPERTIES OF THE BODY. 

Seventeen elements have been found in the human body, viz., oxygen, 
carbon, hydrogen, nitrogen, sulphur, -phosphorus, chlorine, fluorine, 
silicon, sodium, potassium, lithium, calcium, magnesium, iron, manga- 
nese, iodine. The first four make up nearly the whole bulk of the fluids 
and soft solids; the remaining, chiefly in a state of combination, and in 
much smaller quantities, enter into several of the tissues. 

The chemical compounds existing in the body may be classed as 
organic and inorganic. The former contain carbon, hydrogen, oxygen, 
and some nitrogen ; the chief kinds are albumens, fats, and carbohydrates. 
If dried they will burn. The most important are water, common salt, 
phosphate, and carbonate of lime. 

Albuminous or proteid substances are known only as obtained from 
living beings and have never been artificially constructed in the labora- 
tory. The most important are serum albumen, which is very like egg 
albumen, and is found dissolved in the blood; fibrin, which forms in the 
blood when it clots ; myosin, which is found in the muscles ; casein, found 
in milk. 

Fats consist solely of carbon, hydrogen, and oxygen. The chief fats 
in the body are palmitin, stearin, and olein. 

Carbohydrates belong to the same class of substances as starch and 
sugar. The most important is glycogen, a sort of starch found stored 
up in the liver and muscles. 

PHYSICAL PROPERTIES OF THE BODY. 

The Tissues. — The solid organized substances of which the human 
body is composed are called tissues. The more important are the cellular 
or areolar, mucous, serous, dermoid, fibrous, cartilaginous, bony or osse- 
ous, muscular, adipose, nervous. These will be considered in more detail 
in connection with the special organs. 



7 i8 



ANATOMY AND PHYSIOLOGY. 




Inferior Maxillary Bone or 
Lower Jaw Bone. 



Fig. 140. Nasal and Orbital Cavities. 

i, Opening of the nasal fossa. 2, Extremity of 
the inferior turbinated bone. 3, Malar or cheek 
bone. 4, Orbital cavities or sockets. 5, Lachry- 
mal canal through which the tear ducts pass. 6, 
Os planum of the ethmoid bone. 7, Optic foramen 
through which the optic nerve passes. 8, Sphe- 
noid fissure connecting the orbital and cranial 
cavities. 9, Fissure between the sphenoid and 
superior maxillary bones. 10, Great wing of the 
sphenoid bone. 11, Squamous (thin or scale-like) 
portion of the sphenoid. 12, Parietal bone. 13, 
Part of the frontal bone. 14, Mastoid process. 
15, Styloid (pen-shaped, long, pointed) process. 




Fig. 142. The Hyoid Bone. 
The U-shaped bone at the base of the tongue. 




Fig. 143. Thorax. 



1, 2, 3, The sternum or breastbone, likened to a sword, of which 1 is the manubrium or handle; 
2, The gladiolus or little blade. 3, The ensiform cartilage or xiphoid (fish-like) process. 4, The first 
dorsal vertebra. 5, The 12th dorsal vertebra. 6, The first rib. 7, Second rib. 8, Third and suc- 
ceeding ribs. 9, 8th, 9th, and 10th ribs. 10, nth and 12th ribs, known as floating ribs, n, The 
costal cartilages which fasten ends of 8th, 9th, and 10th ribs. 



THE SKELETON. 710 

THE SKELETON, 

The human skeleton is composed of bone, cartilage, and connective 
tissue, and consists of more than two hundred separate bones, though the 
actual number of distinct bones varies at different periods of life; many 
bones which are separate in youth becoming united in old age. 

The bones form the framework of the body, provide levers for the 
muscles, and surround cavities containing delicate organs, as the brain, 
heart, spinal cord, etc. 

Cartilage is found at the ends of bones, where it forms elastic pads 
for the joints; it is sometimes used in place of bone, as at the anterior 
ends of ribs. 

Connective tissue, in the form of stout cords (ligaments), binds bones 
together; as tendons, it attaches muscles to bones; as periosteum, it is 
concerned in nourishing the bones. 

Articulations are points where the bones meet. 

Joints are articulations in which a considerable range of movement 
is permitted. 

THE BONY SKELETON. 

The bony skeleton is usually considered under two parts: the axia. 
skeleton and the appendicular skeleton. 

The axial skeleton supports the head, neck, and trunk ; it is composed 
of 'the skull, hyoid bone, vertebral column, ribs, and sternum. 

The appendicular skeleton supports the limbs and attaches them to 
the trunk ; it consists of the pectoral and pelvic girdles, and the limb bones 
themselves. 

The pectoral arch or girdle consists of two bones : a collar bone 
('clavicle) and a shoulder blade (scapula) on each side. 

The pelvic arch or girdle consists of a single bone {os innominatinn) 
on each side. 

The skull is composed of twenty-eight bones distributed as follows : 
cranium, eight; inside of the ears, six; facial, fourteen; the hyoid bone 
has the tongue attached to it, the bone itself being attached to the undei 
surface of the skull by ligaments. 

The vertebral column consists of twenty-four vertebrae: seven cervi- 
cal; twelve dorsal; five lumbar. 

The sacrum is below the separate vertebrae and the coccyx is at the 
tip of the spine. In adults the sacrum and coccyx consist of one bone 
each; in children, of five and four respectively. There are twenty- four 



720 



ANATOMY AND PHYSIOLOGY. 




Fig. 144. Clavicle or Collar Bone. 





Fig. 145. Scapula or Shoulder Blade. 




Fig. 147. Atlas. 

The ist cervical vertebra, upon which the 
skull rests. It permits the nodding motion of the 
head. Its body is formed by the odontoid process 
of the axis. 




Fig. 146. Spinal Column or Back- 



Fig. 148. Axis. 



The 2d cervical vertebra. It permits the 

A, The seven cervical vertebra. B, The twelve turning of the head from side to side. The upper 

dorsal vertrebra. C, The five lumbar vertebra. projection is the odontoid process around which 



D The sacrum and coccyx. 



the atlas fits. 



BONES. 721 

ribs, twelve on each side ; ending, ventrally, in a costal cartilage. To the 
sternum, or breastbone, are attached most of the ribs and the inner ends 
of the two clavicles. 

There are two clavicles or collar bones, one on each side of the 
sternum, their outer ends being attached to the scapulas, and their inner 
ends to the sternum. 

The two scapulas, or shoulder blades, lie on the back of the chest 
outside the ribs. 

Bones of the arms (thirty in each) : humerus, extends from the 
shoulder to the elbow; radius (forearm bone, thumb side) ; ulna (second 
forearm bone) ; eight carpal (in the wrist) ; five metacarpal (in the palm 
of the hand) ; fourteen phalanges (two for the thumb and three for each 
finger). 

Ossa innominata, one on each side. 

Bones of the lower limbs (thirty in each) : femur (thigh bone) ; 
tibia (lower leg, inside) ; fibula (lower leg, outside) ; patella (kneecap) ; 
seven tarsal (below the ankle joint) ; five metatarsal (in the front half of 
the sole of the foot) ; fourteen phalanges (two in the great toe and three 
in each of the others). 

BONES. 

Structure. — When alive, the bones have a bluish-white color, with 
a pinkish hue if blood is flowing through them. They have considerable 
flexibility and elasticity. The outer layer is compact, while the inner 
portion is spongy and contains red marrow, which is quite different 
from the yellow fatty marrow of the medullary cavity. Compact bone 
is porous. Its cavities' are much smaller than those of spongy bone and 
the hard bony plates between them are thicker. 

Chemical Composition. — Bones are compounded of mineral and 
animal matter; from the former, phosphate and carbonate of lime, they 
receive their strength ; from the latter, cartilage, they derive their life. 

Growth and Nourishment. — Periosteum. The blood circulates 
through the bones, thus nourishing them. The periosteum and marrow 
are necessary to their growth. The blood vessels and nerves spread 
and divide in them before entering the bone proper. The periosteum 
seems to be a part of the bone. If removed, the bone dies, but if the 
bone be removed so as to leave the periosteum in its place, the bone will 
grow again. 

Haversian Canals; Canaliculi. — The former are tubes that run 
through the bone, most of them in the direction of its long axis. They 



722 



ANATOMY AND PHYSIOLOGY, 




Fig. 149. 7th Cervical Vertebra. 

The long projection at the lower part of the figure is the process to which one end of the lig- 
araentum nuchae (which holds up the head) is attached, i, Body. 2, Transverse processes. 3. 
Anterior roots. 4, Openings for the vertebral arteries. 5, Superior articular processes. 6, Infe- 
rior articular processes. 7, Laminae. 9, Spinal foramen through which the spinal cord passes. 




~Fig. 150. Dorsal Vertebra. 

1, Front surface and body. 2, Spinal foramen. 
3, Spinous process. 4, Transverse processes. 5, 
Surfaces to which the ribs are attached. 6, 
Upper articular surfaces. 7, Pedicles. 




Fig. 152. The 12th Dorsal Vertebra. 

1, Attachment of the head of the 12th rib. 2. 
Transverse process. 3, Tubercle of transverse 
process. 4, Lower tubercle. 5, Front tubercle. 
6, Upper articular process. 7, Lower articular 
process. 8, Spinous process. 




Fig. 151. The 1st Dorsal Vertebra. 

1, Upper surface of the body. 2, semi-lunar 
processes. 3. Surface to which the first rib is 
attached. 4, Half of the surface to which the sec- 
ond rib i? attached. 5, Upper articular surface. 
6, Lower articular surface. 7, Transverse process. 
8, Facet for tubercle of the first rib. 9, Spinous 
process. 




Fig. 153. A Lumbar Vertebra. 

i. Surfaces of the body. 2, Transverse proc- 
esses. 3, Spinous process. 4, Upper articular 
process. 5, Lower articular process. 



SPINAL COLUMN. 723 

are united by numerous cross branches, the outermost of which open on 
the surface of the bone beneath the periosteum where blood vessels enter 
to carry materials for the bone's growth and nourishment. 

The canaliculi are extremely line tubes through which liquid, which 
transudes from the blood vessel in the Haversian canal, can ooze through 
the bone. 

Shapes. — Bones are of different shapes : long, as the clavicle, the 
humerus; short, as the carpal and tarsal ; Hat. as those of the skull ; irrep- 
ular, as the vertebrae. 

Joints. — These are of several varieties : ball and socket, as those of 
the hips and shoulders; hinge, the lower jaw bone is hinged to the cra- 
nium ; pivot, the first and second cervical vertebras enable the skull to turn 
to the right and left ; gliding, as those of the closely packed bones of the 
carpus and of the tarsus. The joints are moistened by the synovial 
membranes which line them. 

Comparison of the Upper and Lower Limbs. — The pectoral arch 
answers to the pelvic; the humerus, to the femur; the radius and ulna, 
to the tibia and fibula ; five metacarpal bones, to five metatarsal ; fourteen 
phalanges in the digits of the hand, to fourteen in the digits of the foot ; 
elbow and wrist joints, to knee and ankle. The arm has no separate 
bone at the elbow to correspond to the patella, but the ulna bears a bony 
rrocess which in early life is a separate bone and may be considered as 
corresponding to the patella. The adult carpus has eight bones, the 
tarsus but seven, but, in early life, one of the tarsus (the astragulus) con- 
sists of two bones. The elbow joints bend ventrally and the knee joints 
dorsally. The arms have light and movable parts and serve as prehen- 
sile organs ; the legs are heavy and they are firmly knit so as to carry the 
weight of the body. The lower limbs are proportionally much longer 
in man than the arms, thus making possible a more rapid progression on 
the legs, and a longer stride. 

The spinal column widens gradually from the neck to the sacrum 
and has four curvatures which add to its springiness and prevent the 
transmission of sudden jars. Between the bodies of the twenty-four 
vertebrae are placed elastic cushions known as intervertebral disks. 
These intervertebral disks allow of a certain range of movement between 
each pair of vertebrae. They also aid in protecting the spinal cord from 
injury. Each vertebra consists of the body, a neural arch, a neural 
ring, and bony processes which project from the body and the arch. 
The successive neural rings form the neural tube, in which lies the spinal 
cord. Nerves pass into or out from the spinal cord through the inter- 



724 



ANATOMY AND PHYSIOLOGY. 




Fig. 154. Pelvis. Front View. 

A, Interior iliac fossa. B, Iliac crests. C, Anterior upper iliac spines. D, Anterior lower iliac 
Spines. E, Iliopectineal eminences. F, Horizontal branches of the pubes. G, Bodies and sym- 
physis of pubes. H, Acetabulum into which the head of the femur fits, forming the hip joint. I, 
Tuberosity of the ischium. J, Ascending branch of the ischium. K, Descending branch of the pubis. 
L, Spine of the ischium. M, Coccyx. N, Union of the sacrum and the ischium. O, Union of the 
vertebral column and the sacrum. P, Posterior strait of the pelvis. 




Fig. 155. Os Innominatum. 

The unnamed bone, so-called from its irregular shape, i, Upper border or crest. 2, Front, upper 
iliac spine. 3, Rear, upper iliac spine. 4, Upper curved line. 5, Lower curved line. 6, Space 
between the upper curved line and acetabulum. 7, Front, lower iliac spine. 8, Front interspinous 
notch. 9, Rear, lower iliac spine. 10, Rear interspinous notch. 11, Spine of the ischium. 12, 
Great sacrosciatic notch. 13, Acetabulum into which the head of the femur fits forming the hip 
joint. 14, Bottom of the acetabulum. 15, Border of the acetabulum. 16, Cotyloid notch (a cup- 
shaped depression). 17, Spine of the pubes, the front portion of the bone. 18, Horizontal branch 
of the pubes. 19, Lower branch of the pubes. 20, The ischium, the part upon which the body 
rests when sitting. 21, Groove through which the obturator externus muscle passes. 22, Obtura- 
tor foramen. 



THE HEAD. 725 

vertebral foramina, apertures leading into the neural canal. While the 
vertebrae resemble one another in general form, the first and second 
cervical vertebrae differ considerably from the others. The first (the 
atlas), which carries the head, has a very large neural ring. The second 
has a peg which forms a pivot around which the atlas rotates, thus allow- 
ing the head to be turned from side to side. 

THE HEAD. 

The head consists of the cranium and the face; the former contains 
the brain. The skull _, or skeleton of the head, in early adult life, con- 
tains twenty-two naturally separate bones, but in youth the number is 
greater; in old age, less. Eight of these form the cranium; fourteen, 
the face. Those of the cranium are arranged so as to inclose the brain 
case and to protect the deep parts of the ear. As a general rule, they 
are expanded and plate-like in form. The edges of some of them inter- 
lock in a manner similar to the dovetail joints of cabinet makers, the 
joints being known as sutures. The whole structure is marvelous for its 
strength and lightness. Between the interior and exterior wall of the 
frontal or forehead bone are two hollow chambers, known as the frontal 
sinuses, which cause those bulgings at the upper edges of the orbits, and 
which shelter and protect the eyes in the hollows beneath. 

On the underside of the cranium are many small apertures for nerves 
and blood vessels to pass in or out, and one large opening, the foramen 
magnum, for the spinal cord. 

Fourteen bones support the face and surround the mouth and the 
nose, and, with the aid of some of the cranial bones, form the eye sockets. 
The bones of the face, as a rule, are much smaller than those of the 
cranium. Some have the form of thin scales, while others are more 
irregular in shape. They consist of two superior maxillary, or upper 
jaw bones ; two palate bones ; two malar, or cheek bones ; two nasal bones 
roofing in the nose ; two lachrymal bones, very thin and small and lying 
between the nose and the orbit ; two inferior turbinate bones lying inside 
the nose, one in each nostril chamber; a vomer and an inferior maxilla. 

In its general form, the skull is ovoid, the average capacity of the 
brain cavity being ninety-two cubic inches. The skull of a woman is 
smaller and lighter than that of a man. 

THE MUSCLES. 

The muscles, numbering more than 500 and varying from one-sixth 
of an inch to nearly two feet in length, cover the skeleton almost entirely. 



726 



ANATOMY AND PHYSIOLOGY. 



Fig. 156. 



Humerus or Long Bone of 
the Upper Arm. 



Fig. 157. Radius (shorter) and Ulna 

(longer) Bones of the Lower 

or Fore Arm. 





Fig. 158. 



Bones of the Hand. 
Upward. 



Palm 



Fig. 159. 



Bones Which Form the 
Wrist Joint. 



A, Scaphoid, B, Semilunar. C, Cuneiform. D, 
Pisiform. E, Trapezium. F, Groove in which 
runs the tendon of flexor carpi radialis. G. 
Trapezoid. H, Os magnum. I, Unciform. J, 
Metacarpal bones. K, First phalanges of the 
fingers. L, Second phalanges of the fingers. M, 
Third phalanges of fingers. N, First phalanx of 
the thumb. O, Second phalanx of the thumb. 



R, Radius. U, Ulna. S. Scaphoid. L, Semi- 
lunar. C, Cuneiform. P, Pisiform. T, Trapezium. 
T (inner) Trapezoid. M, Os magnum. Ui Unci- 
form. I, 2, 3, 4, 5, metacarpal bones. 



MUSCLES. 



7*7 



By their contractility, they cause the different bones to move upon each 
other, invest and defend them, hold them together at the joints, and 
inclose cavities, as the abdomen and mouth. Most are rounded but 
some are flat, as those on the sides of the abdomen. They consist of a 
soft red middle part (belly) tapering toward each end into tendons 
which attach the muscles to parts of the skeleton. There are numerous 
varieties: simple (tapering toward each end); biceps or two-headed 
(divided at one end) ; triceps (three-headed), as at the back of the upper 
arm; some have no tendon at either end, the belly itself being attached 
to the bone; penniform (featherlike), where a tendon runs along the 
side of a muscle and the fibers are attached to it obliquely ; bipenniform, 
where a tendon runs down the middle of the muscle; digastric (two- 
bellied), where a tendon is found in the middle of the belly and at each 
end; poly gastric (having more than two bellies, as the two straight 
muscles along the front of the abdomen, each of which consists of four 
bellies separated by short tendons). 

Muscle is composed of bundles of parallel fibers placed side by side, 
and supported and held together by a delicate web of areolar tissue; so 
that if it were possible to remove the muscular substance, we should have 
remaining a beautiful reticular framework, possessing the exact form 
and size of the muscle, without its color and solidity. Each bundle (a 
fasciculus) consists of a number of smaller bundles, and these of single 
fibers, which, from their minute size and independent appearance, have 
been called ultimate fibers; although microscopic examination informs 
us that each one of these is itself a fasciculus, made up of ultimate fibrils, 
inclosed in an extremely delicate sheath, called the myolemma or sarco- 
lemma. The whole muscle is enveloped in a loose sheath of connective 
tissue, known as the perimysium; from it partitions run in and subdivide 
the belly of the muscle into bundles {fasciculi.). 

Of the ultimate muscular fiber there are two sorts in the animal 
economy; that of voluntary or animal life, called striated muscle, and 
that of involuntary or organic life, termed smooth muscle. The former 
is known by its size, its uniformity of caliber, and especially by its trans- 
verse markings, which occur at minute and regular distances. It also 
presents markings, or striae, in a longitudinal direction. The ultimate 
fibers, or fasciculi, are polyhedral in shape, this form being due to mutual 
pressure; and the sizes differ in different classes, genera, and even 
sexes of animals. The ultimate fibrils of animal life are beaded fila- 
ments, presenting a regular succession of segments and constrictions, 
the latter being narrower than the former, and the component substance 



728 



ANATOMY AND PHYSIOLOGY. 




Fig. 160. Section of the Wrist 
Joint. 

Showing the relation of the bones of the wrist to 
one another and the separation by synovial mem- 
branes. 




Fig. 161. Ligaments Which Bind the 
Wrist Bones Together. 

Front view of the right hand. A, The radius. 
B, Membrane between the bones. C, Lower end 
of the ulna. D, Passage for the anterior interos- 
seous artery. E, External side ligament of the 
wrist. F, The ulna. G, Front wrist ligament. 
H, Internal lateral ligament of the wrist. I, 
Scaphoid tubercle. J, Pisiform bone. K, Trape- 
zium bone. L, Unciform bone. M, Point of 
union of the first metacarpal bone with the trape- 
zium. N, Front carpal ligament. O, Ligaments 
uniting the metacarpal bones with the carpal 
bones and with one another. 




Fig. 162. Femur or Long Bone of the 
Upper Leg. 



i 



Fig. 163. Tibia (large bone) and 

Fibula (smaller bone) of 

ihe Lower Leg. 



MUSCLES. 729' 

probably less dense. The ultimate fibril of animal life measures two- 
thousandths of an inch and is composed of a succession of cells connected 
by their flat surfaces. Very different from all this, in its form and 
arrangement, is the ultimate fiber of organic life, it being a simple 
homogeneous filament much smaller than the fiber of animal life — 
flat, smooth, and without traverse markings. It is of a fusiform 
shape and various lengths and consists of a thin external mem- 
brane, blended with a soft, homogeneous, or finely granular contained 
substance. This kind of muscle is distributed very abundantly in the 
animal frame, and is met with in all situations where a distinct con- 
tractile power, independent of mere elasticity, is required. 

Voluntary muscles are generally attached to the skeleton ; involuntary 
are not attached to the skeleton directly, nor concerned in our ordinary 
movements. They lie in the walls of various hollow organs, as the 
stomach, the intestines, and the arteries, and by their contractions they 
move the contents of those cavities. Voluntary muscles have rapidity 
of action and are under the control of the will ; involuntary, comparative 
slowness and act, as a rule, without our knowledge or consciousness. 
The muscular fibers of the heart are intermediate in structure, between 
the voluntary and involuntary kinds, thus making comparatively rapid 
action possible. 

Muscles have cells, contractile elements, accessory connective tissues, 
blood and lymph vessels which convey nourishment and carry all waste 
matter, nerves which govern their activity, water (75 per cent), and 
salts. They are controlled by means of the brain and spinal cord 
through the nerves. 

The belly is the working part of a muscle. The nerves when excited 
cause the muscles to contract and pull on the tendons, thus transmitting 
the pull to the parts to which they are attached. Every contraction is 
accompanied by a loss of or change of material. This waste is repaired 
by the minute muscular fibers or the cells composing them, taking from 
the blood proper food and appropriating it. When the waste of material 
is greater than the supply the muscles become fatigued. Extreme fatigue 
is dangerous because the muscular fibers may become so completely ex- 
hausted that their power of nourishing themselves may be seriously im- 
paired or destroyed; on the other hand, if the muscles remain inactive, 
they waste away and become flabby until the muscular fibers disappear 
altogether, or are filled with little particles of fat which take the place of 
some of the muscular substance, thus making them weak and useless. 
The muscles should not be unduly exercised. It is less fatiguing to walk 



73Q 



ANATOMY AND PHYSIOLOGY. 




Fig. 164. Ligaments and Details of the Hip Joint. 

A, Band of the capsular ligament cut across. B, cotyloid ligament. C, Ligamentum teres, the 
round ligament of the hip. D, Attachment of the ligamentum teres to the head of the femur. E, 
Head of the femur. F, Neck of the femur. G, Band of the capsular ligament cut away from the 
neck of the femur. H, Portion of the neck of the femur outside of the capsular ligament. I, Great 
trochanter, a process on the outside of the femur below the neck. J, Hollow of the great trochanter. 
K, Small trochanter on the inner side of the femur. L, Anterior line running between the two tro- 
chanters. 




Fig. 165. Bones of the Foot. 



I, Os calcis. 2 and 3, Inner and outer tuberosities of os calcis. 4, Angular depression. 5, 
Astragalus. 6, Cuboid. 7, Tuberosity. 8, Scaphoid. 9, Tuberosity of scaphoid. 10, Internal cuneiform. 
11, Middle cuneiform. 12, Apex of internal cuneiform. 13-17, Metatarsal bones. 18, Tuberosity of 
fifth metatarsal. 19, Two sesamoid bones. 20, 21, Phalanges of great toes. 22, 23, Phalanges of 
lesser toes. 



THE BRAIN. 731 

an hour than to stand still an hour because in walking the muscles have 
short intervals of rest, but while we are standing still they have no rest as 
they are continually in a state of contraction. When a muscle is fatigued, 
it recovers very fast, if allowed to rest 

THE BRAIN. 

The brain lies in the skull and is continuous through the foramen 
magnum with the spinal cord, which lies in the vertebral column and 
which should be considered as part of the brain. Its soft pulpy masses 
are placed in almost completely closed bony cavities and enveloped by 
three membranes which give them support; viz., the pia mater, the dura 
mater, and the arachnoid. The pia mater is a very delicate tissue, con- 
taining many minute blood vessels, which are, in fact, the nutrient arter- 
ies of the brain, before entering which they divide and subdivide upon 
the external surface to an extreme degree of minuteness, so as to prevent 
the blood from entering the tender cerebral substance in too forcible a 
manner. The dura mater is a much coarser and stronger membrane, 
which lines the inner portion of the skull, and forms an external cover 
for the brain and its appendages. The outer surface of the pia mater and 
the inner surface of the dura mater pass into a delicate fibrous tissue, 
lined by an epithelium, which is called the arachnoid membrane. Thus 
one layer of arachnoid coats the brain and spinal cord, and another lines 
the dura mater. 

In man the brain is larger and heavier than in the inferior animals 
except the elephant and the larger whales ; that of an ox scarcely weighs 
a pound. The size and weight of the human brain vary not only in the 
different races of mankind but in individuals of the same race and in the 
two sexes, the average weight of which is from forty-nine to fifty ounces 
in the adult European male and from forty-four to forty-five ounces in 
the adult female. The average weight is considerably higher in civilized 
than in savage races. The brain reaches its maximun size between the 
third and eighth years, but it does not reach its maximum density until 
about the thirty-sixth year. After the age of sixty, the brain begins to 
diminish in weight. 

Old People's Brains. — Persons in advanced life should be particu- 
larly careful not to overwork the brain. In middle life, it recovers easily 
from great fatigue. In the decline of life, its powers of recovery are 
feeble. A single exhaustion may cause its fatal collapse. Old age 
should be distinguished for gentleness and moderation. 

Nearly everywhere, the surface of the brain is laid in folds, known 



73 2 



ANATOMY AND PHYSIOLOGY. 




i, Posterior portion of digastric. 2, Stylohyoid. 
3, Anterior portion of digastric, a., Tendon and 
pulley of digastric. 5, Anterior part of right di- 
gastric. 6, Mylohyoid. 7, Hyoglossus. 8, Part of 
right sternomastoid. 9, Part of left sternomas- 
toid. 10, Sternohyoid. 11, Tendon of omohyoid. 
12, Thyrohyoid. 13, Sternothyroid. 14, Inferior cov 
strictor of pharynx. 15, Trachea. 16, (Esophagus. 
17, Rectus capitis anticus major. iS, Longus colli. 
19, Scalenus anticus. 20, Scalenus posticus. 21, 
Levator anguli scapulas. 22, Splenius capitis. 23, 
Splenius colli. 24, Trapezius. 25, Part of sterno- 
mastoid. 26, Retrahens aurem. 27, Part of occipi- 
tofrontal. 28, Deltoid. 29, Pectorales majores 
(cut away). 30, External intercostal. 31, Internal 
intercostal. 



Fig. 166. Muscles of the Neck. 

1, Frontal. 2, Occipital. 3, Aponeurosis. 4, 4. 
Temporal. 5, Retrahens aurem (drawing back the 
ear). 6, Orbicularis palpebrarum. 7, Levator 
labii superioris et alaeque nasi (Raiser of the upper 
lip and sides of the nose). 8, Dilator naris. 9, 
Compressor naris. 10, Zygomatic minor. 11, 
Zygomatic major. 12, Masseter. 13, Levator 
anguli oris. 14, Levator labii superioris. 15, Or- 
bicularis oris. 16, Buccinator. 16A, Depressor 
anguli oris. 17, Depressor labii inferioris. iS, 
Levator labii inferioris. 19, Sternomastoid. 20, 
Trapezius. 21, Digastric and stylohyoid. 22, An- 
terior portion of digastric. 23, Pulley for the ten- 
don of digastric. 24, Omohyoid. 25, Sternohyoid. 
26, Thyrohyoid. 27, Mylohyoid. 28, Splenius 
capitis. 29, Splenius colli. 30, Levator anguli 
scapulas. 31, Scalenus posticus. 32, Scalenus 
anticus. 





Fig. 167. Muscles of the Face and Neck. 



■IS 



i, Buccinator. 2, Masseter. 3, Deoressor labii 
inferioris. 4, Depressor anguli oris. 5, Lower 
part of platysma myoides. 6, Pectoralis major. 7, 
Deltoid. 8, Scalenus posticus. 9, Scalenus anti- 
cus. 10, Levator anguli scapulas. 11, Splenius 
colli. 12, Splenius capitis. 13, Trapezius. 14, 
Retrahens aurem. 15, Occipital. 16, Constrictor 
of pharynx. 17, Sternothyroid. 18, Thyrohyoid, 
'S- 19, Omohyoid. 20, Sternohyoid. 21. Left sterno- 
■19 hyoid. 22, 23, 24, Sternocleidomastoid. 25, Hyo- 
7 glossus. 26, Mylohyoid. 27, Stylohyoid. 28, Ten- 
don and pulley for digastric. 20 and 30, Digastric. 



Fig. 168. Muscles of the Neck. 



MUSCLES OF THE TRUNK. 



733 




Fig. 169. Muscles of the Front of the Body. 



i. Pectoralis major. 2, Attachment of same to the clavicle. 3, Attachment of same to abdominal 
aponeurosis. 4, External oblique. 5, Serratus magnus. 6, Latissimus dorsi. 7, Parts of the pectora- 
les majores. 8, Ensiform cartilage. 9, Aponeurosis. 10, Linea alba (white line). 11, Umbilicus or 
navel. 12, Rectus abdominis. 13, External abdominal ring. 14, Pyramidalis. 15, Rectus abdominis. 
16, Sternohyoid. 17, Omohyoid. 18, Sternomastoid. 19, Trapezius. 20, Deltoid, 21, Biceps. 22, 
Pectineus. 23, Sartorius. 24, Rectus femoris. 25, Tensor vaginal femoris. 



734 



ANATOMY AND PHYSIOLOGY. 




Fig. 170. Muscles of the Back of the Body. 



i, Trapezius. 2, Latissimus dorsi. 3, Aponeurosis connecting muscles of the lumbosacral region. 4- 
Aponeurosis attaching the latissimus dorsi. 5, Attachment of the latissimus dorsi to the ilium. 6, 
Latissimus dorsi, external border. 7, Teres major. 8, Latissimus dorsi curving around the teres 
major. 9, Rhomboideus major. 10, Rhomboideus minor. 11, Serratus posticus superioris. 12, Ser- 
ratus posticus inferioris. 13, Sternomastoid. 14, Splenius. 15, Levator anguli scapulas. 16, Infraspi- 
natus. 17, Teres minor. 18, Teres major. 19, Latissimus dorsi. 20, Attachment cf same to the 
scapulas. 21, Serratus magnus. 22, Internal oblique. 23, Aponeurosis of same. 24, Gluteus maximus. 
25, Gluteus maximus, cut off. 26, Gluteus medius. 27, Pyramidalis. 28. Tendon of gemelli and obtu- 
rator internus. 29, Quadratus f emoris. 30, Longissimus dorsi. 31, Deltoid. 32, Triceps. 



MUSCLES. 



735 




Fig. 171. 



Muscles of Inner Part of the 
Thigh. 



i, Iliacus. 2, Psoas magnus. 3, Obturator inter- 
ims. 4, Pyriformis. 5, Gluteus maximus. 6, 
Sartorius. 7, Gracilis. 8, Semitendinosus. 9, 
Semimembranosus. 10, Tendon of sartorius. 11, 
Tendon of gracilis. 12, Tendon of semitendino- 
sus. 13, Enlargements of same. 14, Tendon of 
semimembranosus. 15, Rectus femoris. 16, Vastus 
internus. 




Fig. 172. Back View of the Triceps. 

This muscle is so called because it has three 
heads, viz.: 1, The long, middle, or scapula head, 
attached to the scapula or shoulder blade. 3, The 
outer or long humeral head, attached to the 
humerus. 4, The short or inner humeral head, 
attached to the humerus. 2, Tendon of the long, 
middle, or scapular head. 5, Common tendon. 6, 
Attachment of tendon to the olecranon process on 
the back of the ulna. 7, Anconeus. 8. Deltoid. 9, 
Lower part of deltoid. 10, Supraspinatus. 11, 
Infraspinatus. 12, Teres minor, cut away. 13, 
Teres minor inserted into the humerus. 14, Teres 
major. 15, Latissimus dorsi. 16, Supinator longus. 
17, Extensor carpi radialis longior. 18, Extensor 
carpi ulnaric. 19, Flexor carpi ulnaris. 




Fig. 173. Sole of the Foot. 
Showing arrangement of muscles and tendons. 



736 



ANATOMY AND PHYSIOLOGY. 




Fig. 174. Muscles ©f the 
Leg. 

i, Tibialis anticus. 2 and 3, 
Tendon of same. 4, Tendons of 
extensor communis digitorum. 5, 
Gastrocnemius. 6, Origin of 
same. 7, Sole us. 8 Tendo 
Achillis. 9, Attachment of same 
to os calcis. 10, Tendon of plan- 
taris. 11, Tendon of tibialis posti- 
cus. 12, Attachment of same to 
scaphoid. 13 and 14, Tendon of 
flexor longus digitorum. 15, Ten- 
don of flexor longus pollicis. 16, 
Adductor pollicis. 17, Vastus 
internus. 18, Sartorius. 19, Ten- 
don of same. 20, Same cut away. 
21, Gracilis. 22, Tendon of same. 
23, Tendon of semimembrano- 
sus. 24 and 25, Tendon of semi- 
tendinosus. 26, Tendon of gracilis 
and semitendinosus. 



Fig. 175. Muscles of the 
Front of the Leg. 

1, Tendon of the quadriceps 
extensor. 2, Extensor proprius 
pollicis. 3, Tibialis anticus. 4, 
Extensor longus digitorum. 5, 
Tibia. 6, Extensor proprius 
hallucis. 7, Peroneus longus. 
8, Peroneus brevis. 9, Soleus. 
10, Popliteus. 11, Extensor 
brevis digitorum. 12, Annular 
ligament. 



Fig. 176. Muscles of the 
Leg. 

1, Tibialis anticus. 2, Tendon 
of extensor proprius pollicis. 3, 
Extensor longus digitorum. 4, 
Tendons of same. 5, Peroneus 
tertius. 6, Attachment of same. 
7, Peroneus longus. -8, Tendon of 
same. 9, Peroneus brevis. to. 
Tendon of same. 11, Gastrocne- 
mius. 12, Soleus. 13, Ten do 
Achillis. 14, Extensor brevis dig- 
itorum. 15, Abductor minimi 
digiti. 16, Rectus femoris. 17, 
Vastus externus. 18, Lower part 
of same. 19, Tendon of biceps 
femoris. 20, Lateral ligament of 
knee. 21, Tendon of popliteus. 



MUSCLES. 



737 





Fig.. 177. Outer Layer of Muscles of the 
Forearm. Palm up. 



Fig. 178. Muscles of the Arm. 



i, Biceps. 2, Fascia of the biceps. 3, Tendon 
which fastens the biceps to the radius. 4, Brach- 
iaiis anticus. 5. Triceps. 6, Pronator radii 
teres. 7, Flexor carpi radialis. 8, Palmaris 
longus. 9, Palmar ligament. 10, Flexor carpi 
ulnaris. 11, Attachment of same to pisiform bone. 
12, Supinator longus. 13, Attachment of same to 
styloid process of the radius. i4 s Extensor carpi 
radialis longior. 15, Extensor carpi radialis bre- 
vior. 16, Extensor ossis metacarpi pollicis. 17, 
Attachment of same to first metacarpal bone. 18, 
Tendon of extensor secundi internodii pollicis. 19, 
Flexor sublimis digitorum. 20, Tendons of same, 

21, Attachment to second phalanges of fingers. 

22, Attachment of tendons of the same to the last 
phalanges of the fingers. 23, Lumbricales. 24, 
Tendon of flexor sublimis. 25, Abductor pollicis. 
26, Flexor longus pollicis. 27, Flexor brevis mia- 
irai digiti. 28, Abductor minimi digitL 



1, Flexor sublimis digitorum. 2, Attachment 
to the epitrochlea. 3, Attachment to the coronoid 
of the ulna. 4, Attachment to the radius. 5, 
Tendons of same to the middle and ring fingers. 
6, Tendons of same to first and little fingers. 7, 
Flexor longus pollicis. 8, Tendon of same. 9, 
Tendons of flexor sublimis. 10, Spaces between 
same. 11, Tendons of flexor profundus. 12, Ten' 
don of flexor brachialis anticus. 13, Tendon of 
epitrochlear muscles. 14, Tendon of biceps. 15, 
Supinator longus 16, Attachment of same to 
styloid process of the radius. 17, Extensor carpi 
radialis longior. 18, Tendon of pronator radii 
teres cut away. 19, Tendon of extensor carpi 
radialis. 20, Triceps. 21, Flexor carpi ulnaris. 
22, Attachment of same to pisiform bone. 23, 
Adductor minimi digiti. 24, Flexor brevis minimi 
digiti 25, Adductor brevis pollicis. 



73§ 



ANATOMY AND PHYSIOLOGY. 





Fig. 179. Deep Layer of Muscles of the 
Forearm. 

i, The tendon, and 2, the head of triceps. 3, 
Anconeus. 4, Attachment of supinator longus to 
the humerus. 5, Attachment of extensor carpi 
radialis longior to the humerus. 6, Attachment 
of same to second metacarpal bone. 7, Tensor 
carpi radialis brevior. 8, Insertion of same into 
third metacarpal bone. 9, Tendon of the deep and 
superficial muscles. 10, Supinator brevis. n, 
Insertion of pronator radii teres into the radius. 
12. Extensor ossis metacarpi pollicis. 13, Exten- 
sor pollicis. 14, Extensor pollicis secundi. 15, 
Extensor indicis. 16, Common tendon of same 
and of common extensor. 17, Tendon of extensor 
minimi digiti. 18, Tendon of extensor carpi 
ulnaris. 19, Flexor carpi ulnaris cut away show- 
ing flexor profundus digitorum. 20, Upper part 
of deep flexor. 21, Ring shaped ligament. '22, 
Interossei. 23, Abductor minimi digiti. 24, Ten- 
dons of extensor digitorum. 



Fig. 180. Muscles of Forearm. 

1, Triceps. 2, Supinator longus. 3, Extensor 
carpi radialis longior. 4, Attachment of same to 
metacarpal bone. 5, Extensor carpi radialis bre- 
vior. 6, Attachment of same to metacarpal bone. 
7, Extensor ossis metacarpi pollicis. 8, Extensor 
primi internodii pollicis. 9, Extensor secundi 
internodii pollicis. 10, Ring shaped ligament, n, 
Extensor communis digitorum. 12, Attachment 
of the four tendons of the same to the four fingers. 
13, Tendon of extensor indicis. 14, Tendon of 
extensor minimi digiti. 15, Extensor carpi 
ulnaris. 16, Attachment of same to fifth meta- 
carpus. 17, Anconeus. 18, Flexor carpi ulnaris. 
19, Ulna. 20, Olecranon process. 21, Interior 
condyle of the humerus. 



THE BRAIN. 



739 




Fig. 181. Base of the Brain. 



i, Corpus callosum, the transverse fibers connecting the two hemispheres of the brain. 2, 
Optic chiasm, where the two nerves meet and partly cross. 3, Tuber cinereum, an elevation 
of gray matter on the base of the brain, and the infundibulum, a funnel-like connection of the 
tuber with the pituitary body. 4, Corpora albicantia, two small protuberances of white 
matter. 5, Pons varolii, connecting the medulla and the crura cerebri. 6, Third nerve or 
motor oculi, concerned in moving the eye. 7, Aqueduct of Sylvius, the canal which connects 
the third and fourth ventricles of the brain. 8, Testes, the posterior two of the four 
corpora quadrigemina composed of gray matter. 9, Omitted, io, Frontal lobe of the brain. 
11, Fissure of Sylvius. 12, Olfactory nerve, the nerve of smell. 13, 14, and 15, Convolutions of 
the frontal lobe, lower surface. 16, Posterior lobe of the brain. 17, Sphenoid lobe. 18, 
Occipital portion. 19, Hippocampus major. 20, 21, and 22. Posterior lobe. 22, Gyrus formi 
catus, cailosgi gyrus, or gyrus of corpus callosum. 



740 ANATOMY AND PHYSIOLOGY. 

as convolutions, which are deeper and more numerous in man than in any 
of the animals. Such inequalities are not found upon the brain of the 
hare or rabbit, nor upon the brains of rodent animals. These inequalities 
are neither so bold nor so deep in the ox as in the horse, nor so well 
marked in the horse as in the dog, seeming to increase or diminish very 
much with the ratio of intelligence, as does also the bulk of the brain. In 
fishes, the brain is very small, and in the invertebrate animals it dimin- 
ishes to mere nervous ganglia. It is curious to observe that while in the 
robin and among birds, the brain approaches to the proportionate size of 
that of the human being, in the goose it bears a very much smaller pro- 
portion to the bulk of the body. 

The cerebral substance is composed of pulp containing both fibers 
and cells. One portion is termed the gray substance, on account of its 
color; it consists of fine cellular membrane, sustaining a complete net- 
work of small blood vessels. Larger in quantity, and firmer in con- 
sistence, is another substance, termed the white or medullary portion. 
It consists of minute fibers woven together like a plaited straw. 

In the medulla oblongata the arrangement of the white and gray 
matter is substantially similar to that which obtains in the spinal cord, 
that is to say, the white matter is external and the gray internal. But in 
the cerebellum and cerebral hemispheres, the gray matter is external and 
the white internal; while, in the optic thalami and corpora striata, gray 
matter and white matter are variously intermixed. 

THE NOSE. 

The nose contains the organ of smell in vertebrate animals, and in 
the three highest classes is connected with the respiratory function. In 
man, the nose, anatomically considered, consists of two large cavities, 
called nostrils, a right and a left, formed by the bones of the face, and 
separated from each other by a perpendicular flat partition called the 
septum. The upper wall of the nose is pierced by numerous foramina, 
through which enter the filaments of the olfactory, or nerve of smell. 

Besides smell, the nose has ordinary sensation, like other parts of the 
face, depending on filaments of the trifacial or fifth pair of cerebral 
nerves. The external prominent part of the nose, which gives character 
to the features, is composed of several cartilages connected to the bones 
and to each other by strong fibrous tissue, sufficiently firm to preserve the 
shape of the organ, and so elastic and flexible as to permit the expansion 
and contraction of the nostrils in respiration. The nose contains not 



THE THROAT. 741 

only the nerves of smell, but serves also for the passage of air into the 
lungs, and has a considerable influence upon the voice. The sense of 
smell resides in the mucous membrane that lines the upper portions of 
the cavity of the nose. The olfactory nerves arise from the under sides 
of the olfactory lobes and pass out through the roof of the nose. Their 
function is to carry to the brain the special sensation of smell. A very 
minute amount of any substance is required to affect the sense of smell. 
A grain of musk will perfume a room for a long time without losing 
appreciable weight. In order to appreciate odors, we must draw the 
odorous air through the nose; hence the act of sniffing. If the air in 
the nasal passages remains stationary, we cannot smell. The uses of 
the sense of smell are to detect improper food and impurities of the air. 

THE THROAT. 

The Pharynx (throat cavity) into which the mouth, nose, gullet 
(oesophagus), and the windpipe open, is lined by mucous membrane and 
has muscles in its walls which, by their contraction, drive the food on to 
the oesophagus. 

The Trachea (windpipe) is the cartilaginous and membranous canal 
through which the air passes into the lungs. It leads downwards along 
the front part of the throat, where it may be readily felt. Its walls are 
strengthened by a series of cartilaginous hoops which are incomplete 
behind, their ends being united only by muscle and membrane. This 
arrangement enables the trachea and its branches to be kept open. The 
trachea is about four and one-half inches long by one inch wide. After 
passing through the- thorax, it divides into two branches (bronchi), a 
right and a left. Each bronchus enters the lung of its own side, and then 
breaks up into a great number of smaller branches which are called 
bronchial tubes. 

The top of the windpipe is called the larynx (organ of voice). This 
is a triangular-shaped box of cartilage whose lower end opens freely into 
the trachea. Its upper end is closed by muscles and membranous tissues 
except an opening (the glottis) which is protected by a plate of cartilage 
known as the epiglottis. The epiglottis may be seen if the mouth is 
opened widely and the back of the tongue pressed down by the handle of 
a spoon. During swallowing it is pressed down like a lid over the 
opening of the air tube and helps to keep food from entering it. 

The larynx is composed of cartilages connected together by liga- 
ments, moved by numerous muscles, is lined by the mucous membrane, 
and supplied with vessels and nerves. The cartilages of the larynx are 



742 ANATOMY AND PHYSIOLOGY. 

nine in number, three single and three in pairs. The vocal ligaments 
(cords) are two narrow bands of dense, fibrous, and highly elastic tissue, 
stretched between the anterior angle of the thyroid and the anterior 
surface of the arytenoid cartilages. They lie in the pharynx so that only 
a narrow slit (the glottis) is left between them. As the air is driven 
through the glottis these cords vibrate and give rise to sounds. The 
longer the vocal cords are, the lower is the pitch of the voice. Children 
have shrill voices because the larynx is small, and for this reason a 
woman's voice is 'usually higher pitched than a man's. About sixteen or 
seventeen years of age, a boy's larynx grows very fast and his voice be- 
comes an octave deeper in tone. 

The Oesophagus is a muscular tube about nine inches long, through 
which food is conveyed from the throat to the stomach. It commences 
at the lower termination of the pharynx and, passing on through the neck 
and chest, ends below the diaphragm, by opening at the cardiac orifice 
of the stomach. In the neck, it lies close behind the windpipe. Its 
direction is nearly straight, having only two or three slight curvatures. 
It consists of three coats: a mucous membrane within; next, a sub- 
mucous membrane coat of areolar muscular tissue ; and, outside, a muscu- 
lar coat made up of two layers. 

The Mouth Cavity is bounded in front and on the sides by the lips 
and cheeks, below by the tongue, and above by the palate, which consists 
of two parts; viz., the hard palate and the soft palate. The hard palate 
is in the anterior part, is supported by bone, and forms the partition be- 
tween the mouth and the nose. The soft palate is in the posterior part 
and is unsupported by bone. It arches down at the back of the mouth 
and hangs like a curtain between it and the pharynx. The uvula is the 
pendent, fleshy lobe in the middle portion of the soft palate. 

The cavity at the back of the mouth, from which the larynx and 
pharynx proceed, is known as the fauces, while the sides of the soft 
palate skirting the sides of the passage, or fauces, form double muscular 
pillars, which are termed the pillars of the fauces. Between these, the 
tonsils are situated, one on each side. The tonsils are round or oval 
shaped glands. In their natural state, they can be discerned easily as 
they project slightly on each side of the fauces; but, when swollen and 
inflamed, as they often are in weakly and scrofulous persons, they are 
very noticeable, being bright red, and often hanging down so as to nearly 
fill the throat, thus rendering swallowing very difficult. The tonsils 
sometimes become enlarged during a cold or sore throat. Occasionally 
the enlargement is permanent and causes much annoyance. The treat- 



HEART AND KIDNEY. 



743 




Fig. 182. Left Side of Heart. 

i, Left auricle. 2, Appendix of the auricle. 3, 
Openings of the pulmonary veins. 4, Pulmonary 
sinus into which the pulmonary veins empty. 5, 
Pulmonary veins. 6, Opening from the auricle 
into the ventricle. 7, Coronary vein. 8, Left ven- 
tricle. 9, Hollow of the left ventricle, a, Mitral 
valve. b, and c, Columnae carneae. D, Arch of 
the aorta. E, Pulmonary artery. F, Ductus 
arteriosus, which in the foetus connects the 
descending aorta and the pulmonary artery. G, 
Left pulmonary artery. H, Right ventricle. 
I, Appendix of right auricle. 





Right Side of the Heart. 



1, Right auricle. 2, Appendix of the right aui i- 
cle. A, Muscular pouch projecting from the inner 
surface of the auricle and overlapping the root of 
the pulmonary artery. 3, Superior vena cava, 
formed by the union of the right and left innom- 
inate veins and the azygos veins. 4, Inferior vena 
cava, formed by the union of the right and left 
Common iliac veins. 5, Fossa ovalis, a depression 
in the right auricle, the connection of the right 
and left auricles. 6, Eustachian valve, separating 
the inferior vena cava from the auriculo-ventric- 
ular opening. 7, Coronary vein, which returns 
blood from the substance of the heart to the right 
auricle. 8, Coronary valve, closing the coronary 
sinus. 9, 'Opening of canal connecting the auricle 
and ventricle. A, Right ventricle. B and C, 
Cavity of right ventricle. E and F, Tricuspid 
valve, which prevents the blood from being forced 
from the right auricle into the right ventricle. G, 
H, I, K, and L, The chordae columnae, or muscles 
by which the tricuspid and mitral valves are con- 
nected to the walls of the ventricle. M, Pulmo- 
nary artery valve. N, Top of left auricular appen 
dix. O, Left ventricle. P, Ascending aorta. Q 
Arch of the aorta. R. Descending aorta. 



Fig. 184. Section through the Kidney. 

A A, Renal artery. B, Ureter. C, Renal calyx, 
D, Cortex. E, Medulla. F, Medullary rays. G, 
Labyrinth. H, Boundary layer of medulla. I, 
Papillary portion of medulla. J, Cross sections of 
tubules. K, Fat cells in renal sinuses. L, Medul- 
lary rays running crosswise. M, Artery. 



744 ANATOMY AND PHYSIOLOGY. 

ment usually adopted in such cases is to remove them, which can be done 
by a competent surgeon without danger. 

THE HEART. 

The heart is the great central organ of circulation. Its form is that 
of a cone having its base directed backward towards the spine and its 
apex forward and downward towards the left side, so that with each beat 
it may be felt striking between the fifth and sixth ribs, about four inches 
to left of the median line. In its natural position it rests upon the dia- 
phragm, having the surface on which it lies somewhat flattened. It is 
inclosed in a moist membranous sack called the pericardium, which 
allows it a free motion without friction. Behind and above, the peri- 
cardium is also loosely attached to the upper and back part of the chest. 

The heart may be described as a hollow muscle, having four cavities, 
two on each side. Its action is that of a double pump, intended to carry 
on the circulation through the body and through the lungs; the auricle 
and ventricle on the left side being devoted to the former, and those of 
the right side to the latter. Each auricle is connected with its corre- 
sponding ventricle by an opening guarded by a valve which opens for the 
blood to pass in the right direction, any attempt to return being instantly 
resisted by the closing of the valves. Should these become disabled so 
that they perform their office imperfectly, there will be regurgitation, or 
return of the blood, which occasions serious derangement of the circu- 
lation, resulting in organic disease. These valves are double folds of 
the serous membrane and are stiffened somewhat by a few fibers which 
run between the folds. All have three flaps except the one between the 
left auricle and left ventricle, which has only two. Papillary muscles 
(chordae tendinese) keep the valve flaps shut across the openings and 
maintain their edges in contact. The walls of the ventricles are thicker 
and more muscular than those of the auricles because they pump the 
blood through the blood vessels. The left ventricle is stouter than the 
right; it 'has to force the blood over most of the body while the right 
sends it over the pulmonary circuit, which is comparatively short. 

The circulation is also spoken of as consisting of two general divi- 
sions : the pulmonary, which carries the blood to, through, and from the 
lungs; the systemic, which guides its flow through all the remaining 
organs. The flow from the stomach and intestines through the liver to 
the inferior vena cava is known as the portal circulation. 

The contraction of any part of the heart, especially that of the ven- 



VESSELS OF THE NECK. 



745 




Fig. 185. Vessels and Nerves of the Neck. 



i, Subclavian artery. 2, Subclavian veins. 3, Common carotid artery. 4, Internal jugular 
vein. 5, Anterior jugular vein. 6, Omohyoid muscle. 7, Sternohyoid muscle. 8, Pneumogas 
trie nerve. 9, Hypoglossal nerve. 10, End of hypoglossal nerve. 11, Descending branch of 
same. 12, Internal branch of cervical plexus. 13, Plexus formed by descending branch of 
hypoglossal and internal branch of cervical. 14, External carotid artery. 15, Superior thyroid 
artery and vein. 16, Lingual and facial arteries. 17, Facial artery and vein. iS, Occipital 
artery. 19, Branches of first four cervical nerves. 20, Superior laryngeal nerve. 



746 ANATOMY AND PHYSIOLOGY. 

tricle to torce out the blood, is called the systole; the relaxation, its 
diastole. The cardiac period is the time from pause to pause. 

The heart not only by its contraction propels the blood, but by its 
expansion it produces suction to draw it up, so that it is at once both a 
suction and a force pump; and such is the power of its action that the 
whole mass of the circulation, about twenty-eight pounds, goes through 
the system in the space of two minutes. 

The contraction on both sides of the heart is simultaneous, commenc- 
ing at the mouths of the veins which open into the auricles. It runs 
over the auricles and is immediately taken up by the ventricles. The 
auricles relax the moment the ventricles start to contract. The ven- 
tricles begin to dilate after ceasing to contract. Then, for a short time, 
neither the auricles nor ventricles contract, but the whole heart expands. 
These contractions and relaxations average about seventy per minute 
in the adult. The rapidity may vary owing- to sudden emotions. 

The sounds of the heart are caused by its alternate contractions and 
relaxations and are known as the first and second sounds of the heart. 
The first is a prolonged, rumbling sound, and the second short and sharp : 
The former is probably due to the vibrations of the tense valve flaps and 
the ventricular wall ; the second, to the closure of the semilunar valves. 

The nerves of the heart receive nervous impulses from the nerve 
centers and cause the contraction of the muscle fibers of the wall of the 
heart, thus producing its beating. 

The heart muscle gets its rest during the pause between contractions. 
thus doing active work during eight hours of the twenty- four. In 
fevers, the heart has less time to rest owing to its more rapid beating, 
and becomes exhausted by overwork. 

THE ARTERIES. 
The Arteries are vessels which convey the blood from the heart; 
they were formerly supposed to contain air only, from their being found 
empty after death. They convey the blood, after it has received a supply 
of oxygen from the lungs, wheresoever it is required for the purpose 
of life. These arteries are membranous, cylindrical tubes composed of 
three coats and have rings of muscular tissue in their walls which con- 
tract and relax. They are highly elastic and extensible, being capable 
of bearing a great amount of strain and pressure to which they are 
occasionally subjected but which sometimes results in a rupture. Ex- 
cept the pulmonary artery and the aorta, which have semilunar valves 
at their origin, arteries have no valves. All the arteries of the systemic 



ARTERIES. 



747 



TEMPORAL A. 
POSTAURICULAR A. 

OCCIPITAL 

EXTCfttfAl CAROTlO 

/MTCRNAL CA*0?«0 

SUP. THYROID 

VERTEBRAL A. 



INTEROSSEOUS A 
RADIAL A 



DEEP 
-p A.LIMAR ARCH 

TALMARARCrt 



"PALMAR. 
^aVoMOS.5 



- INT. |L(AC A 

Con mon femoral 
deep femoral a 

SUPERFICIAL FEMORAL A- 

ANASTOMOSlS AT 
KN££ 



TRANSVERSE FACIAL 



COMMON CAROTID A. 
NF. THYROID A- 
THYROID AXIS 
SUBCLAVIAN A- 
ARCH OF AORTA 




DCRSAL 

ARTERIAL 
ANASTOMOSES 



PLANTAR ANASTOMOSIS 



PERONEAL A. 



POST. TIBIAL A. 



MALLEOLAR BRANCHES 

OF 

ACOVE ARTERIES 



0OR.SAL ARTERIAL ANASTOMOSIS) 



Fig. 186. Arterial System. 



74S ANATOMY AND PHYSIOLOGY. 

circulation proceed from the aorta. This main trunk or channel proceeds 
from the left ventricle of the heart and contains the pure arterial blood, 
known by its bright red color and issuing-, when it makes its escape at 
any accidental opening, in jets, in accordance with the pulsations. 

The large arteries usually lie deep for protection ; the heart pumps 
blood into them with great force and, when an artery is cut, rapid and 
dangerous bleeding occurs. However, some come very near to the sur- 
face. 

Arterial blood is rich in oxygen and poor in carbon dioxide. Its 
coloring matter, haemoglobin, forms a scarlet compound with oxygen. 
The blood flows though the arteries with an average velocity of twelve 
inches per second. The arteries have rings of plain, muscular fiber 
in their walls. When they contract, the artery is narrowed, and when 
they relax it is widened under the pressure of blood from the heart, thus 
carrying more blood to the capillaries of the organ which it supplies. 
These muscles regulate the flow of blood so that parts hard at work 
may receive a sufficient supply; and parts at rest, just sufficient to keep 
them nourished. The main arteries are the aorta, the large artery which 
first receives the blood from the left ventricle of the heart; the femoral 
arteries, the main arteries of the thighs; brachial, of the upper arm; 
radial, of the thumb sides,, and ulnar, of the little linger sides of the 
forearms: the carotid, which supply the front of the head and face, 
the pulmonary, which divides into two branches, one going to the right 
lung and one to the left lung. 

THE VEINS. 

Veins are the channels by which the blood is returned to the heart 
and lungs to be purified. The arteries and veins do not communicate 
directly with each other, but are connected by capillaries. The small- 
est veins arise from the capillary network and unite to form larger 
and larger trunks. In structure the veins are similar to the arteries, 
but they are thinner and, when emptied of their food, they are flattened 
and collapsed. Most veins contain many valves, formed by pouches 
of their lining and resembling the semilunar valves; these valves are 
composed of a thin stratum of nucleated areolar tissue mingled with 
fine., elastic fibers, and coated on the two surfaces with fine, elongated 
cells. The segments or flaps of these valves are semilunar in form 
and arranged in pairs, one on either side of the vessel generally, but 
sometimes there is a single flap which has a spiral direction., and, occasion- 
allv. there are three. The free border of the valvular flaps is concave 



VEINS. 



749 



OCClPlTAU V 

INT. JUGULAR V 
EXX> JUGULAR y. 

• RIGHT AND LEFT 
BRACHIOCEPHALIC VEINS 



CEPHALIC V. 
BASILIC V. 

ffiEOlAN BASILIC V. 
MEDIAN CEPHALIC V. 



SUPERFICIAL VEINS \ 

(RADIAL, MEDIAN, ULNAR, v 
AND POSTULNAR) 



OEEP MEDIAN V 
CAUDAL CAVA 
ixr. ILIAC V 



LONG 5APHENA V 
(SUPERFICIAL). 



IONS Saphena v. 

{SUPERFICIAL) 



TEMPORAL V, 

ACIAL V. 
EXT. ANT. JUGULAR VEltfS 

»NT. JUGULAR V. 

EXT. JUGULAR V. 

SUBCLAVIAN V. 

PULMONARY A. 

\ y AXILLARY V. 

SCAPULAR VEINS 
CEPHALIC V. 

RACHiAL V. 



ABDOMINAL 
AORTA 



^J^VfN/e COMITES 




OR SHORT SAPHENA V, 



VEN/G COMiTES 



SUPERFICIAL 
DORSAL A«CH 



Fig. 187. Venous System. 



/0< 



ANATOMY AND PHYSIOLOGY. 



and directly forwards, so that while the current of blood is permitted to 
flow freely towards the heart, the valves are distended and the current 
intercepted, if the stream from fullness of the veins above or other causes 
should turn back. "When we consider that the course of the venous 
current is upward, and so opposed to the law of gravitation, we shall 
see at once the wisdom of such an arrangement. In the veins of the 
extremities, particularly the deeper ones, they are most numerous; in 
the portal and cerebral, and very small veins, and those of the viscera, 
they are generally absent, and altogether so in the large trunks. 

The veins are nearer the surface than the arteries, each of which is 
usually accompanied by one or two veins ; the largest by one and the 
smaller by two. The jugular veins are the companions of the carotid 
arteries and run close to their sides. These are an exception to the 
rule that veins take their names from the corresponding arteries. The 
venae cavae are the large veins which collect blood from the smaller ones 
and discharge it into the heart through the right auricle. The Latin word 
means, hollow veins. Venous blood is dark purple because of the excess 
of the darker colored haemoglobin, the oxygen having been used in the 
capillaries; but there is one exception. The pulmonary vein carries 
-scarlet blood; the pulmonary artery, black blood. This artery divides 
into two branches ; one going to the right lung and one to the left lung. 
There are two corresponding veins, one from each lung. The blood 
flows through the veins, eight inches per second. The aggregate area 
of the veins is much smaller than that of the capillaries, but greater 
than that of the arteries. There is no pulse in the veins, as they receive 
the even capillary flow of blood. Thus the danger of their rupture is 
diminished. Their walls have to be very thin, that the blood may ooze 
through them to nourish the organs of the body, and that wastes from 
the organs may get to the blood to be carried off. If the blood were sent 
into them in sudden jets, they would be in danger of being torn. 

THE CAPILLARIES. 

The connection between the veins and the arteries is through the 
capillaries. They vary in diameter from 1-2000 to 1-1500 of an inch 
and are so small that only one or two blood corpuscles can pass through 
them abreast. They are formed of a single layer of flat cells and are 
really a continuation of the lining membrane of the arteries, veins, and 
heart; it is through this medium that all the phenomena of nutrition and 
secretion are performed. They are all small alike and are joined on the 
one hand with the terminal ramifications of the arteries, and on the other 



THE BLOOD. 751 

with the minute radicles of the veins. They have but one coat, which is 
transparent and fiberless; as they approach the arteries and veins, this 
becomes thicker. The capillaries are most abundant in the lungs, liver, 
kidneys, and other secreting glands, also in the skin and mucous 
membrane. They are smallest and least abundant in the muscles, nerves, 
organs of sense, and those tissues where nutrition only is accomplished. 
They are large in the bones, but not numerous. 

Their function is to allow the blood to pass from the arteries to the 
veins and do its nutritive work. The liquid containing nourishment 
exudes from the blood through the thin walls to bathe the tissues. Their 
united area is many times greater than that of the arteries supplying 
them. The same quantity of blood flowing through them has a wider 
channel to flow in, the velocity being only one-thirtieth of an inch per 
second. Like the veins, they have no pulse and, hence, the danger of 
rupture is diminished. 

THE BLOOD. 

Blood is a thick, opaque fluid, varying in color from a bright scarlet 
to a dark purple. It has a somewhat viscid feel, a faint odor peculiar to 
itself, and a saltish taste. It contains two kinds of corpuscles, red and 
white. The red corpuscles, which give the blood a red color, are circular 
disks, slightly hollowed out on each face ; their chief constituents being 
water, haemoglobin, salts of phosphorus, and potassium. They are so 
tiny and numerous that about five millions of them are found in a small 
drop of blood. Each appears pale yellow when seen alone under the 
microscope ; they look red only when they are crowded together in a mass. 
They are developed in the red marrow of the bones, thrown into the 
blood current, and are destroyed by the liver. The red corpuscles of 
most mammalia resemble those of man in being circular, biconcave, pale- 
yellow disks ; those of birds, reptiles, amphibians, and fishes are oval 
and contain a nucleus in the center such as is not found in man. Each 
of the white, or colorless corpuscles, is a cell with a nucleus. They are 
a little larger than the red, but very much less numerous — about 1 to 300. 
They have the power of changing their shapes ; of taking into their sub- 
stance and digesting broken down cells and bacteria ; of passing through 
the walls of the capillaries, and moving about through the tissues of 
the body, devouring material of different kinds. The destruction, by 
the white blood corpuscles, of disease-producing bacteria which enter 
through the lungs or mouth is known as phagocytosis. Some argue 
that the white blood corpuscles enable the body to resist many kinds of 



752 ANATOMY AXD PHYSIOLOGY. 

infection (invasion by bacteria) in proportion to the vigor of the cor- 
puscles, but sometimes the bacteria destroy the corpuscles. In these 
struggles the corpuscles sometimes collect in great numbers, filling up 
the tissues and even clogging the circulation of the blood, so as to shut 
off food from themselves and the tissues and contributing" to their own 
destruction. White blood corpuscles are found in great numbers in pus, 
ihe discharge from abscesses. The fluid portion of the blood in which 
corpuscles float is called the plasma and is nine-tenths water. Its most 
important ingredients are albumen and fibrin; it also contains compounds 
of lime, soda, magnesia, etc. When drawn from the body, the blood 
becomes thickened and curd-like, not by evaporation, but by some kind 
of chemical reaction; this process is known as coagulation. The mass 
which separates from the rest of the blood (serum) is the clot. Coagu- 
lation is due to the action of a ferment, fibrin ferment, upon one of the 
proteid substances dissolved in the plasma, fibrinogen; its essential point 
is the formation of fibrin in the plasma. The scrum is the fluid that 
remains after the clot has been separated from the blood. It is a pale- 
yellow fluid and has no fibrin. The blood, while circulating in a healthy 
body, does not clot, because it contains no solid fibrin, but this forms 
in it when the blood gets outside of the body. Coagulation stops the 
bleeding in wounds and closes arteries which have been tied, the ligatures 
crushing or tearing their delicate surface and causing the blood to clot. 
Oxygen and carbon dioxide are the two chief blood gases. The blood 
coming from the lungs is richer in oxygen and poorer in carbon dioxide ; 
in the lungs, the plasma loses its carbon dioxide, which is diffused into 
the air contained in the air cells, while the oxygen of this air is diffused 
into the blood and is taken up by the haemoglobin of the red corpuscles. 
The blood returning to the lungs is richer in carbon dioxide and poorer 
in oxygen because the carbon dioxide pushes its way from the tissues 
into the blood, while the oxygen of the blood enters the tissues to be used 
by them. The total amount of blood in the human .body is from one- 
thirteenth to one-twelfth of the weight of the body. 

Anaemia is a diseased condition of the blood characterized by pallor. 
It is due to a deficiency of red corpuscles and is accompanied by languor 
and listlessness. Fresh air and good food are the proper remedies. 

THE AIR PASSAGES. 

The Thorax or chest is the part of the trunk situated above the 
diaphragm. It is formed by vertebrae behind, the breastbone in front, 
and ribs and cartilages on the sides. The whole is covered air tight by 



THE LUNGS. 753 

the skin, outside, and the pleurae, inside. It can be expanded towards 
the front and sides and downward. 

Air Passages. — These consist of the nose, mouth, pharynx, larynx, 
trachea, bronchi, bronchial tubes, and cilia — the tubes and air passages 
being lined with mucous membrane. The last and smallest of the 
bronchial tubes open into subdivided, elastic air sacs, which are known 
as alveoli, or pulmonary lobules. These are relatively very large, and 
their surface is still further increased by pouches which project from 
them. The blood circulates in a network of capillary blood vessels in 
such a way that it is brought into immediate connection with the atmos- 
pheric air drawn in by each inspiration and obtains from it a supply of 
oxygen and gives up carbon dioxide. Other gases which the air contains 
make their way through the extremely thin membrane of the air cells, 
and thus noxious, as well as healthful, vapors, or gases, are liable to 
be introduced into the circulation, and persons are sometimes poisoned 
by breathing, as well as by eating and drinking, deleterious substances. 

It is estimated that the walls of the air cells, spread out flat and 
placed side by side, would cover an area of 2,600 square feet. Oxygen 
is received and carbon dioxide given off over the great surface. This 
explains the rapidity with which the exchange takes place. 

Cilia are hair-like projections on the free extremities of certain 
epithelial cells of the air passages. They, are in constant motion and 
sweep on the secretion of the mucous membrane, in which they are 
found, to the larynx, where it is coughed up. 

THE LUNGS. 

The Lungs are two in number and consist of bronchial tubes, air 
sacs, blood vessels, lymphatics, and nerves, all bound firmly together by 
elastic tissue. They are situated in the thorax, or chest, and, with the 
heart and larger blood vessels, nearly fill up the chest cavity, so that when 
its walls are compressed, the air is forced out of the minute air cells of 
the lungs into the several elastic tubes (the bronchi) connected with 
them. These bronchial passages afterwards unite and form one tube, 
the trachea, or windpipe, through which the air passes upwards and 
downwards in the act of respiration. The left division of the lungs is 
smaller than the right because the heart, which lies between the two 
divisions, occupies more room on that side than on the other. 

If we examine the structure of the lungs, we find it porous like a 
sponge. When, by action of certain muscles, the capacity of the chest 
is increased, the air rushes in to fill the vacuum and expansion of the 



754 ANATOMY AND PHYSIOLOGY. 

lungs takes place; then the muscular movement ceases, the ribs, by their 
weight and elasticity, contract and force out the air, and this alternate 
contraction and expansion constitutes breathing, in the act of which 
we may see the chest rise and fall. The tubes, air cells, and blood vessels 
of the lungs are held together by what is called cellular tissue. The 
lungs are enveloped in a membrane which covers their surface, and 
also the surface of the chest walls, for which latter purpose it is reflected 
back. This membrane is called the pleura. Its function is to render the 
movements of the lungs painless and easy. Pleurisy is inflammation of 
the pleura. 

The average weight of the lungs in a healthy condition is about forty 
ounces. They are of a conical shape, and internally concave to give a 
place for the heart, and externally convex, to suit the cavity of the chest. 
In their narrow part upward they extend a little above the first rib, 
their broad and slightly concave bases resting upon the diaphragm and 
extending farther down behind than before. They hang free in the 
chest, except where they are attached to the roots, which consist of the 
pulmonary arteries, veins, the bronchial tubes, and other tissue. In 
small children, they are of a beautiful pinkish color; in older persons, 
they are slate-colored and have black spots scattered here and there over 
their surface. 

The lungs of an infant before birth are of dark red, and contracted 
into a small space within the cavity of the chest. They are firm and 
specifically heavier than water, in which, therefore, they sink, whether 
entire or cut into pieces. They also give out little or no blood and no 
air bubbles arise from them. This, therefore, is considered a good 
test as to whether a newly born infant, found dead under suspicious 
circumstances, was born dead or alive. If it has ever breathed, the 
lungs will be expanded with air and float on water; they will be of 
a pale red color, have a loose, spongy texture, fill the cavity of the chest, 
and cover the heart. 

Many of the diseases to which the lungs are liable are, in their 
first stages, of an inflammatory character, and it is important to ascer- 
tain, as soon as they are attacked, in which of the various tissues the 
mischief resides. The condition of the lungs can generally be ascertained 
with tolerable certainty by means of auscultation; the passage of the 
air into and through them gives rise to certain definite sounds well 
understood by the practised ear, when applied to the outside of the chest, 
either with or without a stethoscope. In pneumonia, portions of the 
lungs are solidified so that air penetrates the cells with difficulty, and 



THE NERVES. 755 

in pleurisy the lungs may be surrounded with fluid. In either case, per- 
cussion gives a dull, heavy sound. 

The action of the lungs may be increased by an exercise of the will. 
From fifteen to twenty-two is the average number of respirations in a 
minute, under ordinary circumstances; but this number may be very 
greatly increased by excitement, exercise, or disease. 

The Amount of Work Done by the Lungs. — From 350 to 400 
cubic feet of air are passed through the lungs of an adult man, taking 
little or no exercise, every twenty-four hours, and are charged with car- 
bonic acid and deprived of oxygen, to the extent of nearly five per 
cent. This amounts to about eighteen cubic feet of the one gas taken in, 
and of the other taken out. The quantity of carbon eliminated in the 
twenty-four hours is fairly represented by a piece of pure charcoal weigh- 
ing eight ounces. The quantity of water given off from the lungs in 
twenty-four hours varies very much, but averages nearly a half pint, 
or about nine ounces. 

The Diaphragm is a muscular partition that separates the thorax 
above from the abdomen below. It has a strong, flat, tendinous center, 
from which striped muscular fibers radiate downward and outward in all 
directions, and are fixed by their outer ends to the six lower ribs, the 
breastbone, and the vertebral column. The center rises high in the 
chest, giving it the shape of a vaulted roof, on top of which are the 
lungs and heart, and, underneath, the stomach and liver. In abdomi- 
nal respiration, the diaphragm is used freely; in costal or chest breathing, 
the ribs. The mechanism of respiration is somewhat different in the two 
sexes. In men, the diaphragm takes the larger share in the process, the 
upper ribs moving comparatively little ; in women, the reverse is the 
case, the respiratory act being more largely the result of the movement 
of the ribs. 

THE NERVES. 

The Nerves are the fibers and ganglia of the brain and spinal mar- 
row, which are distributed to every part of the body. There are two 
kinds of nerve substance : one white in appearance and presenting, under 
the miscroscope, a fibrous structure of extremely delicate threads about 
1-2000 of an inch in diameter; the other is of a gray color and consists 
of cells filled with granular matter. These have no medullary sheaths 
like the white, but consist merely of an axis cylinder and primitive 
sheath ; they are but sparingly distributed in proportion to the white, and 
appear to form the apparatus by which the nervous force or energy is 



756 ANATOMY AND PHYSIOLOGY. 

generated, while impressions are conveyed through the white fibers to 
the points of action. We may briefly state, concerning these two kinds 
of nerves, that one gives rise to feeling and the other to motion. 

The Nervous System is the means whereby the collection of dif- 
ferent organs in the human body may be made to work properly. By the 
harmonious operation of these organs, each organ not only looks after 
itself but also adapts its actions to the needs or dangers of the others : for 
instance, the eyelids involuntarily close when an object threatens to 
touch the eye. The bringing of several different things into such rela- 
tions with one another, so that they perform their functions in harmony, 
is known as coordination. 

Nerves are undoubtedly the organs of sensation and motion of 
every kind, and through them the mind operates upon the body. The 
intelligent mind, whose seat is the brain, zvills that a certain action shall 
be performed, and instantly through the spinal cord the message flies, 
branching off here and there, according to the direction in which the 
work is to be done, and setting in motion the muscles which perform it. 

The spine contains the great channel of nervous energy and it is the 
principal support of the bony frame. Like the veins and arteries, the 
nerve fibers and cells spring from great main channels, which may be com- 
pared to the stem and arms of a tree, and branch out from thence in every 
direction, dividing and subdividing into the most minute ramifications, so 
that you cannot so much as prick any part of the surface of the body but 
pain is felt, a sure evidence that a nerve has been touched. The nerves 
take cognizance of the slightest sound, the faintest ray of light, the least 
change in the constitution of the air we breathe; they are vigilant senti- 
nals, ever watching to guard the body from danger, the constant ministers 
to its pleasure and delight. They are often abused and their sensibilities 
perverted or deadened, when they become subject to disease and are 
likely, by a long train of suffering, to avenge the injury done them. 

NUTRITION. 

The organs of nutrition are generally classed as receptive and excre- 
tory. Receptive organs gather new material from the outside for the 
use of the body, and are divided into two sets ; the first, represented by 
the alimentary canal, receive oxidizable things and take in food and 
drink; the second set consists of the lungs with the air passages leading 
to them and, as receptive organs, they absorb oxygen. Excretory 
organs get rid of the waste material formed in the body. The most 



THE STOMACH. 757 

important are the lungs, which give out carbon dioxide gas and water; 
the kidneys, which get rid of urea and water; the skin, which gives out 
water, common salt, and a minute quantity of urea. 

The digestive organs make solvent juices and pour them upon the food 
which is swallowed, in order to get it into a liquid state which will permit 
it to soak through the walls of the stomach and intestines. By means of 
the blood vessels much of the dissolved food passes into the blood vessels 
of the alimentary canal and is carried to every organ. The lymphatics 
take up some of the dissolved food and carry it into the blood vessels. 
By means of the respiratory organs, oxygen is conveyed to the lungs, 
where it is picked up by the blood, in its circulation, and carried to every 
part of the body. Assimilation means the building and repairing of 
tissues and organs from the dissolved food obtained from the blood 
and from oxygen conveyed to it. These ooze through the walls of the 
blood vessels and are taken up by the living tissues and built into 
new tissues like themselves, to replace the parts that have been 
used up and destroyed. Disassimilation, the converse process of as- 
similation, which accompanies all vital action, is the breaking down 
into wastes of a living tissue when it works. The wastes of each 
working tissue pass into the lymphatics, which are found not only 
in the walls of the alimentary canal but all over the body, and are 
carried by them into the blood vessels. These in turn convey the 
wastes to the lungs, kidneys, and skin, which get rid of them. Oxidation 
is the union of oxygen with other substances. The body is kept 
warm by oxidation ; when materials are oxidized in the body, some of the 
energy set free appears as heat. 

THE STOMACH. 

The Stomach is a curved, conical, elastic bag, with muscular cells 
composed of smooth, muscular fibers and lined by an epithelium. 
Through the oesophagus it receives masticated food, which is further 
acted upon by the gastric juice and converted into chyme. It is situated 
in the left hypochondriac and epigastric region, and, when distended, it 
has the shape of an irregular cone, having a rounded base and being 
curved upon itself. The left extremity is the larger and because 
it is on the heart side of the body it is called cardiac dilation. The 
oesophagus opens into the stomach near the middle of the whole 
length of the organ by the cardiac orifice; while, by the pyloric 
orifice at the other end, the digested matter enters the small intestine. 



758 ANATOMY AND PHYSIOLOGY. 

When moderately distended, it is almost twelve inches long, four 
inches across its widest parts, and contains about three pints. The 
stomach has four coats named successively, from without in, as the 
serous, the muscular, the submucous, and the mucous. The serous coat 
is a thin, smooth, transparent, elastic membrane formed by a reflection of 
the peritoneum. The muscular coat is very thick, and consists of 
unstriped muscular tissue arranged in three layers — longitudinal, cir- 
cular, and oblique. The submucous coat is made up of lax areolar tissue 
and binds loosely the mucous coat to the muscular. The mucous coat, 
lining the wall of the stomach, is a moist, inelastic membrane, and has 
multitudes of small glands which open on its surface. These glands 
throw out a thin acid fluid, the gastric juice, when food passes into 
the stomach. It is large enough to line the stomach evenly when it is 
fully distended, but it is thrown into folds when the stomach is empty 
and shrunken. 

At the pyloric orifice, the muscular fibers form a sort of sphincter, 
which contracts the aperture and prevents the passage of any matter into 
the small intestines until properly digested. In the muscular coat of the 
stomach are many nerve cells. The food is propelled along the 
oesophagus by the contraction of the muscular rings of that organ, and 
enters the stomach in successive waves. The fibers of the muscular coat 
run in different directions and by their contractions the food is stirred up 
and mixed with the gastric juice in a peculiar churning motion, its object 
being a thorough intermixture of the gastric fluid with the alimentary 
mass, and a separation from the remainder of that portion which has been 
sufficiently reduced. This motion causes not only a constant agitation 
of the contents, but also moves them slowly along from one extremity to 
the other. These revolutions are completed in from one to three minutes, 
being slower at first than after chymification has become more advanced. 
The passage of the chyme, or product of the gastric digestion, through the 
pyloric orifice into the commencement of the intestinal tube is at first 
slow; but, when the digestive process is nearly completed, it is trans- 
mitted in much larger quantities. 

THE INTESTINES. 

The Intestines form that part of the alimentary canal which extends 
from the stomach to the anus. They are divided into the small and the 
large intestine. The small intestine commences at the pylorus and ends, 
after many windings, in the large. It is about twenty feet long and nar- 
rows from about two inches in width at its gastric end to about one and 



THE INTESTINES. 759 

two-thirds inches at its lower portion. Externally, there are no 
lines of subdivision on the small intestine, but it is described by 
anatomists as consisting of three parts : the first twelve inches being 
the duodenum; the succeeding two-fifths of the remainder, the jejunum, 
so called because it is usually found empty after death, and the rest, the 
ileum. Like the stomach, the small intestine has four coats : a serous, a 
muscular, a submucous, and a mucous. Throughout the greater portion 
of its length the mucous coat of the small intestine is raised into perma- 
nent folds, which run traversely for a greater or less way around the 
tube. These folds are known as valvulae connivcntes and greatly increase 
the surface of the mucous membrane, both for absorption and secretion ; 
they also delay the food somewhat in its passag'e, since it collects in the 
hollows between them and is thus longer exposed to the action of the 
digestive liquids. The mucous membrane is covered everywhere by 
minute projections, known as the villi; they contain blood vessels and 
lacteals by which the nutritious portion of the food is absorbed. Small 
glands, the crypts of Lieberkuhn, open on the surface between the bases 
of the villi. The muscular coat of the small intestine is composed of two 
layers of muscular tissue, the inner being circular and the outer, longi- 
tudinal. By their contractions, they force the food along the tube. The 
large intestine forms the last portion of the alimentary canal. It is about 
five feet long and from one and one-half to two and one-half inches 
in diameter. Anatomists divide it into three divisions : the caecum, with 
the vermiform appendix; the colon, and the rectum. The small intes- 
tine opens into the large intestine by the ileo-caecal valve, not at the com- 
mencement of the large intestine, but at its side, some distance from its 
closed upper end. The caecum is that part beyond the opening; from 
it projects the vermiform appendix, a narrow tube about four inches 
long and of about the thickness of a pencil. Appendicitis is inflammation 
of the vermiform appendix. The colon commences on the right side of the 
abdominal cavity, where the small enters the large intestine, ascends 
on that side {ascending colon), crosses the middle line (transverse colon) 
below the stomach, and descends on the left side (descending colon), 
making an S-shaped bend known as the sigmoid flexure ; from this the 
rectum proceeds — so called because it is in nearly a straight line — to 
the anal opening. 

The large intestine has the same coats as the small. The mucous 
coat possesses no villi nor valvulae conniventes ; it is usually thrown into 
folds like those of the stomach, but smaller. It contains numerous glands, 
which are much like the crypts of Lieberkiihn of the small intes- 



?6o ANATOMY AND PHYSIOLOGY. 

tine. The ileo-csecal valve allows matter to pass readily from the ileum 
into the large intestine, but not the reverse way. The villi have every 
variety of shape, from oblong, curved, and serpentine ridges, to the 
laterally flattened cone standing on its base. 

The small intestine receives secretions formed by the glands imbedded 
in its walls, and also those of the liver and pancreas, the ducts of both 
opening by a common aperture into the duodenum about four inches 
from the pylorus. 

The Pancreas or Sweetbread is a single glandular organ of a 
pinkish-yellow color, lying along the great curvature of the stomach. It 
is of an irregular, elongated form, from six to eight inches in length, an 
inch and a half in breadth, and from half an inch to an inch thick. In 
structure, the pancreas resembles the salivary glands, but it is looser and 
softer in texture. It secretes a watery-looking secretion, called the 
pancreatic juice, the office of which is to emulsify fats so that the lacteals 
can absorb them. The amount daily secreted by a man is from five to 
seven ounces, and it is most abundant at the commencement of digestion. 
It is drained by a duct, which enters the common bile duct. 

THE LIVER. 

The Liver is the largest gland in the body, ordinarily weighing 
from fifty to sixty ounces. It lies under the short ribs, rather more on 
the right than on the left side and immediately below the diaphragm, with 
which its upper surface is in contact, while its lower surface touches 
the intestines and the right kidney. It is invested by a coat of peritoneum, 
which keeps it in place. It is of a dark, reddish-brown color and of a 
soft, friable texture. Its form is irregular, being convex and smooth 
above, where it fits into the cavity of the lower surface of the diaphragm, 
and irregularly concave below. It is thick behind, but ends in a thin 
edge in front. A deep fissure incompletely divides it into two principal 
lobes— -the right and left lobes — of which the former is much the larger; 
several minor lobes are marked off on its under surface by shallow 
grooves. A duct passes out from each half of the organ, uniting to 
form the hepatic duct, into which empties the cystic duct which proceeds 
from the gall bladder. The common bile duct, formed by the union of 
the hepatic and cystic ducts, opens into the duodenum. 

The liver, like other viscera of the abdomen, receives an investment 
of that cavity, the peritoneum, beneath which is a dense connective 
tissue, forming the capsule of Glisson. Offsets from this canal run in 
and line canals, the portal canals, which are tunneled through the organ. 



THE SPLEEN. 761 

The liver is built up of a vast number of minute polygonal masses, or 
lobules, each of which is very granular and consists of a number of 
hepatic cells, separated from neighboring lobules by connective tissue. 
The secretion of bile, though the chief of the functions of the liver, is 
not the only one which it has to perform ; important changes are effected 
in certain constituents of the blood, in its transit through this gland, 
whereby they are rendered more fit for their subsequent purposes in 
the animal economy. Its cells take out of the blood excess of sugar and 
store it up in the form of a kind of animal starch (glycogen), which 
they afterwards give out again as sugar when the blood needs it. The 
liver receives all the blood from the stomach and intestines (the portal 
system). Its cells destroy old red corpuscles and it is believed that they 
are the means of oxidizing nitrogenous materials into urea, in which 
form they are excreted by the kidneys. The retention of the materials 
of the bile in the blood acts like a poison, and, if the suspension of 
secretion is complete, death soon takes place. 

The blood vessels of the liver are the hepatic artery and veins, and 
the portal vein. The liver receives two kinds of blood : arterial, for the 
nourishment of the gland, and venous, from which the bile is principally 
formed ; the former brought directly from the aorta by the hepatic artery, 
the latter by the portal vein from the capillaries of the stomach, intes- 
tines, pancreas, and spleen. 

The Gall Bladder is an oblong, membranous receptacle, situated on 
the concave side of the liver, under the right lobe. It is about the size 
of a small hen's egg and resembles a pear in shape. It serves as a 
reservoir for the bile, which, when digestion is not going on, regurgitates 
through the cystic duct, and is retained for future use. 

The Spleen is an elongated, flattened, red body, abundantly supplied 
with blood by an artery (splenic artery), which proceeds almost directly 
from the aorta. It lies on the left side, just under the diaphragm, and 
close to the stomach and pancreas. Its size is very variable; enlarging 
during digestion and shrinking after it until the next meal. There is 
much doubt as to the real function of the spleen. It was thought by 
the ancients to be the seat of melancholy. The blood of the splenic vein 
is found to contain proportionally fewer red corpuscles, but more color- 
less corpuscles and more fibrin than that of the splenic artery; and it 
has been supposed that the spleen is one of those parts of the economy 
in which the colorless corpuscles of the blood are especially produced. It 
is not an essential organ; animals from which it has been completely 
removed can live a long time in good health. 



7 62 ANATOMY AND PHYSIOLOGY. 

THE SKIN. 

The Skin, although apparently very simple in its structure, is a 
very compound organ. It is not only the seat of common sensation, but, 
by means of the vapor which it constantly emits in the form of perspira- 
tion, it becomes the great regulator of the heat of the body. For 
these purposes, it is supplied with nerves, blood vessels, and glands. 
It has two layers : the cuticle or epidermis (outer), and the dermis or true 
skin (inner), of which hairs and nails are excessively developed parts. 
The epidermis consists of cells arranged in many layers and united by 
a cementing substance. It is penetrated by the ducts of the sweat 
glands, which have their mouths along the ridges. Nerves penetrate 
the deeper layers, but no blood vessels enter it. The dermis is made 
up of strong, interlacing fibers of connective tissue. It contains lym- 
phatic nerves, blood vessels, hair bulbs, sweat glands, and sebaceous 
glands. The upper surface is covered with papillae. The under surface 
merges into the loose connective tissue (subcutaneous areolar tissue), 
which lies between the skin and the flesh. Fat accumulates in this and 
permits the skin to be moved, easily and with no pain, over the tissues, 
immediately beneath it. The thickness of the skin varies from one- 
fiftieth (eyelids) to about one-sixth of an inch (small cf the back). 
In blisters, the epidermis is separated from the layer beneath it by the 
fluid which fills the vesicle, thus showing the thickness of the epidermis. 
The papillae are minute projections from the outer surface of the derma, 
and contain the terminations of nerves and blood vessels. They are 
about one-hundredth of an inch in length, and one-two-hundred- 
fiftieth of an inch broad at the bottom. In some parts of the body they 
are scattered irregularly on the surface of the derma, and in other 
regions, as on the palm of the hand and on the fingers, they are arranged 
in rows. In these the sense of touch is most highly developed. The 
skin is provided with two distinct sets of glands : sebaceous and sweat. 
The sebaceous glands are generally situated near the roots of hairs and 
secrete a peculiar, fatty matter from the system, while the secretion 
itself prevents the skin from being dried and cracked by the influence 
of the sun. These glands are distributed more or less closely over 
the whole surface of the body, but are most numerous in those parts 
which are largely supplied with hair, such as the scalp and face, and 
are thickly distributed about the entrances of the various passages into 
the body as the nose, lips, and external ear. They are altogether 
absent in the palms of the hands and the soles of the feet; they appear 



THE SKIN. 763 

to be made up of an aggregate of small vesicles, and these small vessels 
are filled with an opaque white substance, something like soft ointment. 
These glands are overspread with minute capillaries or blood vessels, 
and their ducts open either into the surface of the skin, or directly 
into the follicles of the hair. These follicles are, in fact, among the 
secretory organs of the skin, since it is only at their root that the material 
produced from their walls is appropriated to the growth of hair. All 
the rest goes to anoint the hair and the surface of the skin. Hence it 
is that the secretion is much more abundant in the inhabitants of 
tropical climates than in those who inhabit cold countries. But for 
this benevolent provision of the great Creator, the skin would become 
parched and dry; and, even with this provision of nature, the natives, 
of warm countries are in the habit of lubricating their skin with vegetable 
oils of various kinds, to protect it from the scorching influence of the 
solar rays. When the openings of these sebaceous glands are closed, 
the glands continue to secrete and a swelling appears. The retained 
secretion causes inflammation, which continues until the contents of the 
inflamed sac are removed. This is the cause of little pimples or boils.. 
The sweat glands are microscopic tubes reaching down from the surface 
of the skin to the loose connective tissues just beneath it (subcutaneous 
areolar tissue). They are found all over the skin, but are most abun- 
dant in the palms of the hands, the soles of the feet, and the brow. They 
are about one-fifteenth of an inch in length and one-four-hundredth of 
an inch in diameter. 

The watery vapor which passes off through the pores of the skin is 
called insensible perspiration, when the quantity is not sufficient to be 
noticed; sensible perspiration or sweat, when it is so profuse as to collect 
in drops on the surface. It consists chiefly of water, with a small pro- 
portion of muriate of soda and free acetic acid. The quantity is at all 
times very considerable, but it is greatly increased during violent exer- 
cise, or in hot weather. The sweat gland possesses a twisted duct, which 
passes upward to the surface, and through this tube ascends to the sur- 
face the perspiration, sensible and insensible. It is estimated that there 
are about twenty-eight miles of this tubing on the surface of the human 
body, and that, on an average, from two to three pounds of water daily 
reach the surface through these channels, and are evaporated. It is sup- 
posed that at least one hundred grains of effete nitrogenous matter are 
daily thrown off from the skin. If this secretion is checked or arrested, 
it throws additional labor on the kidneys; if it remains in the blood, 
it will prove fatal to life and health. Great attention should be given 



764 ANATOMY AND PHYSIOLOGY. 

to the functions of the skin, so as to keep the pores open and its action 
free; and for this purpose nothing is so efficacious as bathing in water 
of suitable temperature, followed by friction and exercise. 

When the skin is subjected to pressure, it becomes thicker in spots 
where the pressure occurs; where the epidermis is affected, the skin 
becomes callous. If the derma be affected, the papillae become enlarged 
and project above the surface, and warts are produced. Where both 
forms of growth take place, we have corns. The under part of the 
epidermis varies in the amount of coloring matter and in thickness; 
hence the difference of complexion in different persons. Where persons 
have no color at all, except the red tinge given by the blood, they are 
called albinos. The pigment cells seem to protect the parts beneath from 
the action of the sun ; sometimes the effect of the sun causes the coloring 
matter to gather in spots, producing freckles. Hairs are slender threads 
of epidermis which develop on special dermic papillae placed at the bot- 
tom of hair follicles. They consist of the stem and the root which is 
buried in the hair follicle. Each hair is made up of a number of epidermic 
cells arranged to form a fiber. The hair of the Caucasian is cylindrical 
or flat, that of the negro is flattened or ribbon-like and, hence, it is 
inclined to curl. The center of each hair is hollow and filled with pig- 
ment cells which contain different coloring matter; hence the difference 
in the color of the hair in different persons. Hair covers nearly the entire 
surface of the body, except the palms of the hands and soles of the feet, 
but most of it is of a soft, downy variety. 

THE URINARY SYSTEM. 

The function of the organs of this system is to separate the urine 
from the blood and to cause it to be removed from the body. These 
organs are the kidneys, the ureters, the bladder, and the urethra. 

The Kidneys are two glandular bodies situated in the lumbar region, 
one on each side of the spine, in what is usually called the small of the 
back, where they lie imbedded in fat. They are four or five inches long 
and two and a half inches broad. Their shape is like the kidney bean and 
they weigh about half a pound each. Each of them is supplied with 
blood from the abdominal aorta by a renal artery, the blood being 
returned to the inferior vena cava by the renal veins, one of which 
leaves each kidney. From each of them issues a duct called the ureter, 
which conveys the urine to the bladder. The kidneys are composed of 
two very different structural arrangements — the outer, or cortical, por- 



THE BLADDER. 765 

tion being, as it were, granulated, and the inner, or medullary, being 
fibrous, arranged in pyramids or cones, with their bases resting upon 
the cortical substance, and their apices, or points, opening into a central 
cavity, the pelvis of the kidney, or, as it has been called, the brain of 
the kidney, which may be regarded as an expansion of the upper portion 
of the ureter. 

The ureters are membranous tubes, of about the diameter of a goose 
quill, eighteen inches long, which run down the back wall of the abdomen, 
behind the peritoneum, to the bladder, into each side of which they empty 
their urinary secretion. The openings of the ureters enter the walls 
of the bladder very obliquely, so that, when the pressure in the bladder 
rises above that of the liquid in the ureter, the walls of the oblique 
passage are pressed together and it is closed. 

The Bladder is situated in the pelvis, or basin, in front of the rectum. 
It is a thin, membranous sac, a receptacle for the urine secreted by the 
kidneys, until it is voided through the urethra. It is attached to the 
rectum, to the hip bones, to the peritoneum, and to the navel, by 
several ligaments. In the female, the bladder has the womb between it 
and the rectum. It is composed of three coats or membranes : the 
external is serous; the middle, muscular; and the internal, mucous. 
The external coat is strong and fibrous. The internal is drawn into 
wrinkles which make it thick and shaggy; it secretes a mucus which 
prevents it from being injured by the corrosiveness of the urine. The 
bladder, which contains muscular tissue in its walls, is usually relaxed, 
thus permitting the urine to flow readily into it from the ureters. 

The urine is a highly complex fluid secreted from the blood by the 
kidneys, containing many solid matters in solution which are no longer 
of service in the body, and which, if retained, would act as a poison. 
In a healthy person, when recently voided, it is a clear, limpid fluid of a 
pale-yellow or amber color, with a peculiar faint, aromatic odor, which 
becomes pungent and ammoniacal when decomposition takes place. 
Often, however, as it cools, it becomes opaque and turbid from the 
deposition of part of its constituents previously held in solution, and 
this may be consistent with health. The urine is retained in the bladder 
by means of a circular muscle, called a sphincter, which closes the part 
called the neck of the bladder, where it joins the urethra. When the 
quantity of urine is so increased as to give some uneasiness or pain, 
the bladder contracts and presses on its contents, the ureters are closed 
in the way explained above, the sphincter of the bladder relaxes, and the 
urine is discharged through the urethra. The urethra is a membranous 



766 ANATOMY AND PHYSIOLOGY. 

canal which leads from the neck of the bladder. It is composed of 
two layers : a mucous and an elastic fibrous. Through this channel, 
which is curved in its course, the urine passes out of the body. 

The quantity and composition of the urine vary greatly, according 
to the time of day; the temperature and moisture of the air; the fast- 
ing or replete condition of the alimentary canal; and the nature of the 
food. It is especially diminished by anything which promotes per- 
spiration, and increased by conditions, as cold to the surface, which 
diminish the skin excretion. An average healthy man excretes by the 
kidneys about fifty ounces, or twenty-four thousand grains of water 
a day. Normal urine consists, in 1,000 parts, of about 960 water and 
40 solids. The solids are mainly urea and uric acid, but small quantities 
of pigments and of non-nitrogenous organic bodies are also present, 
and a considerable quantity of mineral salts. The gases are the same 
as those in the blood ; namely, carbonic acid, oxygen, and nitrogen. But 
me quantity is, proportionally, less than one-third as great; and the 
carbonic acid is in very large, while the oxygen is in very small, 
amount. 

GENERATIVE ORGANS. 

The organs of generation in the male are: (1.) The testes and 
their envelopes, namely: the scrotum; the dartos, which corrugates or 
ridges the scrotum, and the fibrous tunics by which they are invested. 
We must also here include the epididymis, the vas deferens or excretory 
duct, the spermatic cord, and the spermatic artery. (2.) The vesiculse 
seminales, forming a receptacle or reservoir, situated beneath the blad- 
der, for holding the seminal fluid secreted by the testicles. (3.) The 
prostate gland, surrounding the neck of the bladder and the com- 
mencement of the urethra. (4.) Cowper's glands, a pair situated be- 
low the prostate. (5.) The ejaculatory ducts. (6.) The penis, which 
consists of the corpus cavernosum, the urethra, the corpus spongiosum, 
which terminates in the glans penis; then there are the vessels, nerves, 
and a cutaneous investment. 

The principal female organs of generation are: (1.) The ovaries. 
(2.) The Fallopian tubes. (3.) The uterus and its ligaments. 
(4.) The vagina. (5.) The vessels and nerves. (6.) The external 
organs of generation, which it is needless to describe. 

The Perinaeum is the space between the anus and the external parts 
of the generative organs and is named thus from being frequently 
moist. The operation of cutting for stone in males is usually performed 



THE EYE. 767 

here, and here it is that serious injury sometimes occurs, when persons 
fall with their legs astride of any object, or get a bruise while in that 
position, as on horseback ; bloody urine, or complete stoppage, may be the 
consequence, arising from inflammation of the bladder or urethra. 

We abstain from giving cuts of these several parts and organs for 
sufficiently obvious reasons; in a book intended for family use they 
would be objectionable. With regard to the diseases which more im- 
mediately affect them, a few simple remarks will be made under their 
several heads ; but we would here impress upon our readers the necessity 
of at once seeking medical advice for all affections of the genital organs. 
It is in the treatment of this peculiar class of diseases that advertising 
quacks reap their richest harvest, often entailing great present sufferings 
and fearful after-consequences. There is no class of men so dangerous 
to the masses as the self-styled "Doctor," who travels about the country 
advertising to cure all ailments of mankind. 

THE EYE. 

The eyeball, globe of the eye, or organ of vision, is a complex optical 
apparatus imbedded, to a large extent, in loose fat, and attached behind 
to the optic nerve. On its exterior are attached the tendons of several 
muscles, by which the eyeball is moved. Its form approximates to the 
spheroidal but it really consists of segments of two spheres, the posterior 
being the larger and having set on to its front a portion of a sphere of 
smaller radius, which forms the anterior transparent segment of the 
eye; from side to side it is about one inch in diameter, and from before 
back, about nine-tenths of an inch. When we take a side view of the 
eye, we see the anterior portion projecting like a bow window, as it were; 
it is, in fact, the window of the chamber, and through it pass the rays 
of light, which form images on the retina within, of outward scenes 
and objects. In general terms, the eyeball may be described as con- 
sisting of three coats, or tunics, which inclose three translucent refracting 
media. The lines encircling the globe represent the coats by which the 
humors are kept in their places. 

The first external coat consists of a posterior, white, opaque part, 
the sclerotic, which is seen between the eyelids, as the white of the eye, 
and of an anterior, translucent part, the cornea. Both are tough and 
strong, being composed of dense connective tissue, and are covered by 
a thin layer of the conjunctiva. 

The veins of the choroid coat are known as the venae vorticosae, 



768 ANATOMY AND PHYSIOLOGY. 

from the peculiar manner of their arrangement. The external layer 
of the choroid towards the front, of the eyeball is thrown into plaits, 
the ciliary processes, the processes being continuous with the iris, a 
structure which lies behind the cornea and which forms the colored 
part of the eye seen through the Qornea. The middle or arterial layer 
of this coat is composed chiefly of the ramifications of minute arteries. 
The internal layer is composed of minute six-sided cells, which are 
arranged like a tessellated pavement and contain much pigmentary matter 
of a dark brown color. These pigment cells are separated from the 
vitreous humor by the retina, the rods and cones of which are in im- 
mediate contact with them. The pigment in the iris determines the color 
of the eye. The choroid does not, like the outer one, completely envelop 
the eyeball. 

The retina, the third coat, is a still less complete envelop than the 
second tunic, extending forward only as far as the commencement 
of the ciliary processes. The fibers of the optic nerve spread out in the 
retina, penetrating the sclerotic and choroid. At the place where the 
optic nerve enters, the retina is whiter than elsewhere and presents an 
elevation, the optic mound. The yellow spot (maculae lutea) lies out- 
side the optic mound, nearly at the posterior end of the axis of the 
eyeball. The veins and capillaries of the retina are completely invested 
by perivascular lymphatic sheaths, while the arteries only possess such 
sheaths for a limited part of their course. The foramen, which sig- 
nifies an opening, has been found to exist only in" animals which have 
the axes of the eyeballs parallel with each other, as man, the quadru- 
mania, and some saurian reptiles. 

On entering the eye, a ray of light passes through the following 
refractory media : the cornea, the aqueous humor, the crystalline lens, 
and the vitreous humor. The aqueous humor, a limpid, watery fluid, 
containing a little common salt in solution, fills the space between the 
cornea and the front of the crystalline lens. 

The crystalline lens is situated behind the iris and pupil and in front 
of the vitreous humor. It is colorless, transparent, and biconvex, with 
its posterior surface more convex than the anterior, and with its circum- 
ference surrounded. It is invested by a capsule and in front lies in 
contact with the inner edge of the iris. It is retained in place by the 
suspensory ligament of the lens. It is built up of concentric layers, the 
central layers being more dense than the outer. In consistence it is soft, 
but it is denser and capable of refracting light more strongly than either 
of the humors. The vitreous humor, which is rather a soft jelly than a 



THE EVE. 769 

regular fluid, is enveloped in a thin capsule, the hyaloid membrane. This 
membrane splits in front into two layers, one of which forms the sus- 
pensory ligament of the lens, the space between the two layers being 
known as the canal of Petit. The vitreous humor consists of water, 
salts, albumen, and mucin, but the main part is water. 

A brief summary of the uses of the different parts of the eye will 
assist in studying it as an optical instrument. The sclerotic coat .is 
simply one of protection; the cornea is a medium for the admission 
of light; the choroid contains blood vessels to nourish different parts 
of the eye, and by its pigmentary matter absorbs all scattered rays of 
light, by which an image impressed on the retina might be confused. 
The iris, by its power of expansion and contraction, regulates the 
quantity of light admitted through the pupil; when the light is too 
strong, the retina is irritated and, by reflex action, the iris contracts; 
when there is not sufficient light, it relaxes and the pupil enlarges to 
admit more light. The iris covers the edges of the crystalline lens and 
allows the light to come through the center and near parts only, thus 
preventing spherical and chromatic aberration. By means of the 
crystalline lens, light is brought to a focus on the retina. In far-sighted 
or hypermetropic eyes, the lens is too flat or the eyeball is too flat or the 
eyeball is too short, causing the rays to focus behind the retina ; in near- 
sighted or myopic eyes, the eyeball is elongated, causing the rays to 
focus in front of the retina, the rays crossing each other and blurring 
the image. Glasses aid vision by regulating the rays of light as they 
enter the eye and causing them to focus on the retina. Sometimes the 
choroid fails to absorb the light when it is intense and it is reflected 
through the retina, thus confusing the sight. Albinos are troubled 
with dimness and confusion of sight because the coloring matter of the 
choroid coat is absent. 

The convexity of the crystalline lens is controlled by muscles which 
make it greater when we look at near, and less when we look at distant, 
objects; this adjustment, to correspond with the varying distance of 
external objects, so that their images may fall upon the retina, is known 
as the function of accommodation. The ciliary muscle, by contracting 
and relaxing, assists in the function of accommodation. In healthy eyes, 
the inner limit of distinct vision is usually about six inches from the cornea ; 
without artificial assistance, the eye cannot distinguish objects perfectly 
in their minute details, beyond a distance of fifty feet. When the optic 
nerve is stimulated, as by a shock to the retina, it transmits it to the 
brain under the form of light. If the eyeball is struck, we see sparks 



770 ANATOMY AND PHYSIOLOGY. 

or flashes of light even in the dark ; this proves that the optic nerve 
conveys only the sensation of light. 

The appendages to the eye are the eyebrows {super cilia) and the 
eyelids {palpebrae). The eyebrows are two prominent arches of integu- 
ment, covered more or less with thick, short hairs, and forming the upper 
boundary of the orbits; their obvious utility is to shade the eyes from 
too vivid a light, and to protect them from particles of dust and moisture 
from the forehead. The eyelids consist of integuments, muscles, carti- 
lages, glands, and the mucous membrane called the conjunctiva, which 
covers the whole of the anterior surface of the eye, and is reflected back 
so as to form the internal layers of the lids. They have been called the 
"curtains of the eyes" and protect the eyes, when closed, as in sleep. 
On examining the inner aspect of the eyelids, the Meibomian glands 
can be distinctly seen, arranged like strings of pearls, about thirty, on 
the cartilage of the upper lid, and somewhat fewer in the lower, where 
they are shorter than those above, as they correspond in length with 
the breadth of the cartilage. Each of these glands consists of a single 
lengthened follicle, or tube, into which a great number of small clustered 
glandular vesicles open; and from these tubes the secretion is poured 
out upon the margins of the lids, which, being thus kept constantly 
moist inside, are in a condition to lubricate and wash the surface of the 
cornea, which they do in the motion of winking. 

The eyelashes {cilia) are important organs of defense for the deli- 
cate surface of the eye, for whose curtains they form, as it were, 
a silken fringe. 

THE EAR. 

The Ear, the organ of the sense of hearing, is a complex acoustic 
apparatus and consists of three parts, known respectively as the external 
ear, the middle ear or tympanum, and the internal ear or labyrinth. The 
external ear consists of the pinna or auricle, and the external auditory 
meatus; the former collects the sound waves, and the latter conve}^ 
them to the internal ear and is about one and a quarter inches in length. 
The pinna or auricle is the trumpet-shaped, cartilaginous structure 
situated at the side of the head. It consists of an uneven piece of yellow, 
elastic fibrocartilage invested by integument, except the lobule, which 
consists merely of a fold of integument containing fat. The external 
meatus leads from the bottom of the concha (the deep hollow of the 
pinna) into the temporal bone and is closed at its inner end by the 
tympanic or drum membrane. The wall of the outer end-is formed of 



THE EAR 



771 



cartilage and membrane; that of the deeper end, of the plate-like tym- 
panic part of the temporal bone. The skin lining the auditory canal is 
very thin, and closely adherent to the cartilaginous and osseous portions 
of the tube. It is continued over the membrane of the tympanum in the 
form of a thin pellicle, forming its outer covering, and in it are situated 
numerous hairs, together with ceruminous glands which secrete the 
well-known yellow earwax. 

The tympanum, drum, or middle ear is an irregular chamber situated 
in the temporal bone, and interposed between the bottom of the meatus 
auditorius and the labyrinth or inner ear. It is filled with air, and com- 
municates, at its interior 
wall, with the nasal part of 
the pharynx immediately be- 
hind the inferior turbinal, by 
means of the eustachian 
tube ; at its posterior wall, it 
communicates with the air 
sinuses in the mastoid tem- 
poral. The tympanic cavity 
is traversed by an irregular 
chain of three small movable 
bones, connecting the mem- 
brana tympani with the laby- 
rinth and serving to convey 
the vibrations of air which 
strike the membrana tym- 
pani, across the tympanic cavity to the internal ear 



Incus 
Malleus. 

Stapes 




■£emi Circular Canals. 
Vestibule 
Cochlea 



Fig. li 



Front View of the Ear. 



These bones 



are the malleus or hammer, the stapes or stirrup-shaped, and the 
incus; they are moved by muscles, and are bound together and connected 
with the tympanum by ligaments. The tympanic membrane stretches 
across the outer side of the tympanum and is concave on its outer and 
convex on its inner surface ; this membrane is a thin semi-transparent 
substance, nearly oval in form and consists of three layers. It is pressed 
on the external side by the external air, and on the interior side by the 
air entering the tympanic cavity through the eustachian tube. This 
tube is usually closed, but every time we swallow it is opened, thus 
equalizing the air pressure in the cavity to that in the external auditory 
meatus ; if the tympanum were closed, the drum membrane would bulge 
in or out as the barometric pressure varied. If the eustachian tube 
were always open, we would be disconcerted by the loud sounds of our 



JJ2 ANATOMY AND PHYSIOLOGY. 

own voice. Frequent swallowing movements will greatly alleviate pain- 
ful tension of the drum membrane, caused by sudden and great change 
of aerial pressure, such as we experience in making a balloon ascent 
or in going rapidly down a deep mine. 

The Internal Ear, called from its complex construction the labyrinth, 
is divided into three parts ; namely, the vestibule, the semicircular canals, 
and the cochlea. It consists of a series of cavities channeled out of the 
substance of the petrous bone, communicating externally with the cavity 
of the tympanum, and internally with the meatus auditorius internus, 
which contains the auditory nerve. Within the osseous labyrinth is 
contained the membranous labyrinth, upon which the ramifications of the 
auditory nerve are distributed; it has the same divisions as those of the 
bony labyrinth. 

The Vestibule is the central part of the bony labyrinth and has on its 
exterior the oval foramen, into which the base of the stirrup bone fits. 
It lies between the tympanum and the bottom of the internal auditory 
meatus; the semicircular canals are behind it, the cochlea being placed 
in front of it. The bony semicircular canals are three in number and 
are named superior, posterior, and external. They communicate with 
the back of the vestibule at each end and dilate at one end to form an 
ampulla. They are about one-twentieth of an inch in diameter. 

The bony cochlea, so called from its resemblance to a small shell, 
is by far the most complex part of the labyrinth and is placed almost hor- 
izontally in front of the vestibule. Its length is about one-fourth of an 
inch and its width, at the base, about the same. It is a tube wound spirally 
two and a half times around a central pillar, or modiolus, both the pillar 
and the tube diminishing rapidly in diameter from the base to the apex of 
the cochlea. A delicate lamina is contained within the canal, following its 
windings and subdividing it into passages by a plate of bone, the osseous 
spiral lamina, which, springing from the modiolus, winds spirally around 
it and projects into the tube. The whole inner surface of the labyrinth, 
including the semicircular canals and the passages of the cochlea, is 
lined with a thin, fibrous membrane, the outer surface of which adheres 
closely to the bone, while the inner is covered with a single layer of 
epithelium, like that on serous membranes, and secretes a thin serous 
fluid. The membranous internal ear is filled by a watery fluid called the 
endolymph; the space between the bony labyrinth and the membranous 
internal ear, by a similar fluid called the perilymph. The auditory nerve, 
which is distributed over the different parts of the labyrinth, enters by 



THE TONGUE. 773 

the meatus auditorius internus, and divides into two branches; an 
interior for the cochlea, and a posterior for the membranous labyrinth. 
Physiology and physics consider sound from different standpoints; 
the former treats of it as a sensation produced by air waves striking 
the ear drum, the effect being communicated to the brain; the latter, as 
a movement of the air in waves without regard to the sensation. The 
different qualities of sound depend on the different length, rapidity, 
height, and character of the air waves. Colds in the head affect the 
hearing by causing the membrane around the mouth of the eustachian 
tube to swell. The imflammation sometimes reaches the middle ear and 
the chain of little bones becomes stiffened so that they do not conduct 
the vibrations of the membrane of the tympanum; thus permanent deaf- 
ness may result. 

THE TONGUE. 

The Tongue is composed of muscular fibers ; between these fibers is 
a considerable quantity of adipose substances, and in the middle is a 
vertical septum of fibrous tissue. The tongue is attached by its root 
to the hyoid bone. Numerous small eminences or papillae are found on its 
upper surface; these are of three forms — circumvallate, fungiform, and 
-filiform. The circumvallate lie near the root of the tongue and number 
from seven to twelve ; each is an elevation of the mucous membrane. The 
fungiform are rounded elevations and are found all over the middle and 
fore parts of the upper surface of the tongue. The filiform papillae, the 
most numerous and smallest, are scattered all over the dorsum of 
the tongue, except near its base. The taste goblets are buried in the 
epidermis of the circumvallate and in some of the fungiforms. 

The papillae contain blood vessels and nervous filaments from two 
sources; the glossopharyngeal nerve and the gustatory nerve. The 
former chiefly supplies the back of the tongue and the adjacent parts 
of the palate ; the latter, the front of the tongue, the region which is more 
especially the seat of the sense of taste. Most of the taste sensations are 
complex sensations into which smell and even touch largely enter. When 
the sense of smell is interfered with, as when the nose is held tightly 
pinched, it is very difficult to distinguish the taste of various objects. 

The mucous membrane, as well as the form of the tongue, is liable 
to considerable changes in appearance, indicative of disordered states 
of the system. It is on this account that it is so often examined by 
physicians in diagnosing diseases. When the digestive organs are 
deranged, the tongue is commonly covered with a thick, yellowish coat, 
and there is frequently a "bad taste in the mouth " 



774 ANATOMY AND PHYSIOLOGY. 

The structure of the mucous membrane of the tongue differs in 
different parts. That covering the under surface of the organ is thin, 
smooth, and identical in structure with that lining the rest of the oral 
cavity. The mucous membrane on the anterior part of the dorsum of 
the tongue is thin, whilst that at the root is much thicker and looser. It 
consists of a layer of connective tissue, the coriarn or mucosa, supporting 
numerous papillae and covered, as well as the papillae, with epithelium. 

THE TEETH. 

When the child is born the jaw is covered with gums, but under- 
neath the gums are vascular and nervous papillae inclosed in dental sacs; 
there are five on each side of each jaw, making twenty in all. Each 
papilla gradually assumes the form of the future tooth, and as it keeps 
on growing it at last presses upon the gum and, causing it to absorb, 
finally breaks through it. The process is called dentition. It is fre- 
quently a source of disordered health to children, especially if anything 
occurs to prevent the absorption and ready yielding of the gum to the 
pressure of the tooth below. 

First or Milk Teeth. 

2 lower middle incisors, 4th to 8th month. 

2 upper middle incisors, 4th to 8th month. 

4 lateral incisors, 4th to nth month. 

4 anterior or first molars, 12th to 18th month. 

4 eye or canine teeth, 16th to 22d month. 

4 back molars, 19th to 38th month. 

20. 

Order of Appearance of the Permanent Teeth. 

4 first molars, one on each of the two sides of the two 

jaws, 6th to 7th year. 

4 middle incisors, two in each jaw,. . .7th to 8th year. 

4 lateral incisors, a little later than the last, 

7th to 8th year. 

4 first bicuspids, 8th to 9th year. 

4 last bicuspids, 1 ith to 12th year. 

4 eye or canine teeth, 1 ith to 13th year. 

4 second molars, 12th to 14th year. 

4 back molars or wisdom teeth, .... 18th to 30th yean 

32. 



BOOK XI. 

MATERIA MEDICA 

EMIL BUEHLER, Ph.G. 

New York College of Pharmacy ; Dispensing Pharmacist Northwestern Hospital, New York City. 

Materia Medica is the science which deals with the sources and 
preparations of drugs and other medical agents. The term is of 
Latin origin and means medical matter or material. 

A drug is any substance, either simple or compound in its chem- 
ical or physical nature, either in its natural or in a prepared state, 
either by itself or in union with other substances, used as a medical 
agent. There is no feature of the history of drugs of which 
Materia Medica does not treat. Drugs are classified upon a three- 
fold basis : — 

1. As to their source, origin, or derivation. 

2. As to their effects upon the several organs and functions of 

the human body. 

3. As to their prepared state according to the rules of pharmacy 

and their standard strength according to fixed formulas. 

Sources. — Medicine draws upon the vegetable, mineral, and 
animal worlds for its curative agents. The contributions are most 
abundant from the vegetable world, and fewest from the animal 
world. 

Drugs of Vegetable Origin. — Sometimes the medicinal property 
extends to every part of a plant equally; but generally it is lodged 
in some part only. The flowers, seeds, fruits, leaves, roots, or bark 
of many plants are represented in the list of curative agents. The 
active principle upon which the curative properties depend may in 
a few cases be derived by steeping to form an infusion; or by 
boiling to make a decoction; but in the great number of cases they 
are derived by intricate and complex chemical processes in which 
special apparatus is employed. From the vegetable world are 
derived alkaloids, oils, gums, resins, oleo-resins, sugars, starches, 
glucosides, albuminous compounds, and many principles. The 
most important of these products are the alkaloids. 

Drugs of Mineral Origin. — The earth yields many important 
inorganic compounds of great service in medicine : the alkalies, 
alkaline earths, metals, acids, and the great class of carbon com- 
pounds and coal-tar products. 



776 MATERIA MEDICA. 

Drugs of Animal Origin. — These are few in number but include 
such valuable agencies as cod-liver oil, Spanish flies, pepsin, pancre- 
atin, and the useful vehicles lard and lanolin. 

Physiological Effects of Drugs. — It is important to remember 
that a drug may manifest its power in more than one way. In 
classifying them, however, recognition is made of only the most 
important and remarkable of the characteristics of a drug and all 
of its minor or less valuable effects are ignored. This principle 
greatly simplifies what would otherwise be an extremely difficult 
work in classification as to their effects. If notice were taken of 
all of the effects of a drug, the same agencies would appear in many 
of the divisions. Another difficulty in classification lies in those 
individual peculiarities of patients which are known among medical 
men as "idiosyncrasies." In many cases there is such marked 
susceptibility to the effects of a drug in even small doses as to 
entirely prohibit its use. As a rule sensitive and nervous tempera- 
ments respond most quickly to the effects of a drug and conse- 
quently require much smaller doses than do the coarser-fibered and 
more phlegmatic. 

The ability of the human body to accommodate itself to the 
long-continued use of drugs and to tolerate larger and larger doses 
is the underlying cause of the formation of what we call the "drug 
habit." The body on the other hand has a remarkable power of 
storing up in its tissues the excess of drugs which it is unable to 
excrete as rapidly as supplied. From this results what is known as 
the "cumulative effect" of drugs. 

CLASSIFICATION OF DRUGS ACCORDING TO THEIR 
PHYSIOLOGICAL EFFECTS. 

i. Absorbents. — Drugs which cause absorption and exudation 
of diseased tissues. 

Iodine and the iodides. 

2. Alteratives. — Drugs which in some unknown way alter or 
change pathological or morbid conditions and modify the nutrition 
of the body. 

Antimony. Gold Chloride. 

Arsenic. Iodine. 

Cod-liver Oil. Mercury. 

Colchicum. Sarsaparilla. 



MATERIA MEDICA. 777 

3. Anaesthetics. — Drugs which produce unconsciousness and 
insensibility to pain. They arc divided into general anaesthetics, 
which produce unconsciousness, and local anaesthetics, which affect 
only the part to which they are applied. 

General Anaesthetics. 

Alcohol. Ether. 

Chloroform. Nitrous Oxide. 

Local Anaesthetics. 

Carbolic Acid. Ethyl Hydrate. 

Cocaine. Intense Cold. 

Eucaine. 

4. Analgesics or Anodynes. — Medicines which allay pain. 

General Analgesics. 

Belladonna. Narcotics. 

Hypnotics. Stramonium. 

Local Analgesics. 

Aconite. Cocaine. 

Carbolic Acid. Menthol. 

Chloroform Liniment. Opium. 

5. Antacids. — Drugs which neutralize acids in the stomach or 
bowels. 

Salts of Lithium. Salts of Sodium. 

Salts of Potassium. 

6. Antagonists. — Drugs which counteract the effects of other 
drugs. They differ from antidotes in that they may be used after 
the drug has entered the system, when the use of antidotes would 
be too late. 

7. Anthelmintics. — Drugs which are used to kill and expel 
worms; vermicides and vermifuges. 

Alum. Senna. 

Filix Mas. Sodium Chloride or Common 

Pelletierine. Salt. 

Pepo (Pumpkin Seed). Spigelia. 

Quassia. Tannin. 

Santonin. Turpentine. 

8. Antidotes. — Drugs which act upon poisons while they are in 
the alimentary canal and before they are absorbed into the system. 



77 8 



MATERIA MEDICA. 



They act by combining with the poisons and change their chemical 
composition, or remove them. 

9. Antilithics. — Drugs which prevent the deposit of urinary 
sediment, which causes calculus or stone in the bladder. 

Ammonium Benzoate. Potassium Salts. 

Benzoic Acid. Salicylic Acid. 

Lithium Salts. Sodium Salts. 

Lycetol. Uricedin. 
Piperazin. 

10. Antiperiodics. — Medicines which prevent the recurrence of 
attacks of a periodic disease. 

Eucalyptus. Quinine. 

Hydrastis. 

11. Antiphlogistics. — Medicines which counteract fevers by 
reducing the temperature. 

12. Antipyretics. — Medicines which reduce the temperature of 
the body in fevers. 

Acetanilid. 

Aconite. 

Antipyrin. 

Asaprol. 

Chinolin. 

13. Antiseptics. 

Boric Acid. 
Carbolic Acid. 
Corrosive Sublimate. 
Creolin. 



Cold. 

Guaiacol. 

Phenacetin. 

Quinine. 

Resorcin. 

Agents which prevent the growth of bacteria. 
Iodoform. 
Salicylic Acid. 
Thymol. 



■Drusrs which relieve convulsions or 



14. Antispasmodics. 

spasms. 

Alcohol. 
Amyl Nitrite. 
Aromatic Oils. 
Asafoetida. 
Bromides. 
Camphor. 

15. Aperients. — Laxatives or mild purgatives. 



Chloroform. 

Ether. 

Hoffman's Anodyne. 

Musk. 

Valerian. 



Castor Oil. 
Figs. 

Glycerine. 
Magnesia. 



Olive Oil. 
Prunes. 
Sulphur. 
Tamarinds. 



MATERIA MEDICA. 779 

16. Astringents. — Drugs which condense tissues, contract ves- 
sels, and reduce the secretions from mucous membranes. 

Acetic Acid. Iron Salts. 

Alum. Lead Salts. 

Bismuth Salts. Nutgalls. 

Catechu. Silver Salts. 

Copper Salts. Tannic Acid. 

Gallic Acid. Zinc Salts. 
Hamamelis or Witch Hazel. 

17. Cardiac Depressants or Sedatives. — Medicines used to 
lessen the force and frequency of the heart's action. 

Aconite. Ergot. 

Antimony. Pilocarpin. 

Digitalis. Veratrum Viride. 

18. Cardiac Stimulants. — Medicines used to increase the force 
and frequency of the heart's action. 

Alcohol. Chloroform. 

Ammonia. . Ether. 

Atropin. Strychnine. 

19. Carminatives. — Medicines which relieve flatulence and 
griping and expel wind from the stomach and intestines. 

Asafcetida. Cinnamon. 

Camphor. Ginger. 

Capsicum. Musk. 

Cardamom. Peppermint. 

20. Cathartics. — Purgatives. 

Simple Purgatives. 

Aloes. Glycyrrhiza or 
Cascara Sagrada. Licorice Powder. 

Castor Oil. Rhubarb. 

Eupatorium. Senna. 

Drastic Purgatives. 

Aloes. Gamboge. 

Colocynth. Jalap. 

Compound Cathartic Pills. Podophyllum. 

Croton Oil. Scammony. 

Elaterium. 

Saline Purgatives. 

Magnesium Salts or Sodium Salts. 

Epsom Salts. Saline Waters. 

Potassium Salts. Hunyadi, etc. 



780 MATERIA MEDICA. 

21. Caustics or Escharotics. — Medicines used to destroy living 
tissues. 

Acetic Acid, Glacial. Lime. 

Antimony Chloride. Mercury Nitrate. 

Bromine. Nitric Acid. 

Carbolic Acid. Silver Nitrate. 

Caustic Potash. Sulphuric Acid. 

Caustic Soda. Zinc Chloride. 
Copper Nitrate. 

22. Cholagogues. — Medicines which excite a flow of bile. 

Cholagogue Cathartics. 

Blue Mass. Iris. 

Calomel. Podophyllum. 

Gray Powder. 

23. Demulcents and Emollients. — Medicines used to soothe and 
protect irritated tissues and mucous membranes. Demulcents are 
mucilaginous emollients. 

Acacia or Gum Arabic. Lanolin. 

Barley Water. Licorice. 

Borax. Lycopodium. 

Cacao Butter. Olive Oil. 

Flaxseed. Starch. 

Glycerine. Tragacanth. 

Lard. Vaseline. 

24. Deodorants. — Medicines which remove or conceal odors. 
Charcoal. Potassium Permanganate. 
Chloride of Lime. Sulpho-Naphthol. 
Chlorinated Soda. 

25. Detergents. — Medicines employed to cleanse wounds, sores, 
and ulcers. 

26. Diaphoretics. — Medicines which cause increased flow of 
perspiration, thereby assisting or relieving the kidneys and reducing 
the temperature. 

Acetanilid. Dover's Powder. 

Alcohol. Eupatorium. 

Ammonium Compounds. Heat, Artificial. 

Antimony. Nitrous Ether. 

Antipyrine. Pilocarpine. 

Asaprol. Potassium Salts. 

Camphor. Salicylates. 



MATERIA MEDICA. 781 

27. Disinfectants. — Substances which destroy disease germs or 
the harmful effects of fermentation and decay. The number of 
disinfecting agents is very large. 

Aristol. Hydrogen Peroxide. 

Benzoin. Iodoform. 

Bichloride of Mercury. Lime. 

Bismuth. Lysol. 

Boric Acid. Naphthalin. 

Borax. Oxalic Acid. 

Carbolic Acid. Permanganate of Potash. 

Chlorine. Pyrogallol. 

Creolin. Quinine. 

Dermatol. Salicylic Acid. 

Eucalyptus, Oil of.. Sulphurous Acid. 

Europhen. Thymol. 

Formalin. 

28. Diuretics. — Medicines which increase the flow of the urine. 
Convallaria. Sodium Salts. 

Digitalis. Spirits of Niter. 

Diuretin. Squill. 

Liquor Potassse. Strophanthus. 

Potassium Salts. Water. 

Stimulant Diuretics. 
Alcohol. Cubeb. 

Buchu. Juniper. 

Cantharides. Taraxacum or Dandelion. 

Capsicum. Turpentine. 

Copaiba. Zea Mays. 

29. Ecbolics. — Drugs which cause contraction of the uterus 
when gravid or following childbirth. 

Cotton-root Bark. Quinine. 

Ergot. Rue. 

Hydrastis. Savine. 

30. Emetics. — Medicines which cause vomiting. 
Alum. Salt. 
Apomorphine. Tartar Emetic. 
Ipecac. Warm Water. 
Mustard. Zinc Sulphate. 

Antiemetics prevent nausea and vomiting. 
Bromides. Cocaine. 

Carbolic Acid. Creosote. 

Cerium Oxalate. Iodine. 

Chloral. Limewater. 

Chloroform, Morphine, 



782 MATERIA MEDICA. 

31. Emmenagogues. — Medicines which stimulate, restore, and 
regulate menstruation. 

Aloes. Myrrh. 

Cod-liver Oil Pulsatilla. 

Ergot. Rue. 

Hot Bath. Savine. 

Hydrastis. Strychnine. 

Iron. Tansy. 

Manganese. Viburnum Prunifolium. 

32. Epispastics or Vesicants. — Blisters. 
Cantharides. Mustard. 

33. Expectorants. — Medicines which increase or alter the char- 
acter of the secretions of the pulmonic mucous membranes. 

Acids. Benzosol. 

Alkalies. Creosote. 

Ammonium Carbonate. Ipecac. 

Ammonium Chloride. Senega. 

Antimony. Squill. 

Balsam of Peru. Terebene. 
Balsam of Tolu. 

34. Galactagogues. — Medicines which increase the flow of 
milk. 

Castor Oil Leaves. Milk. 

Liquids. Pilocarpus. 

Antigalactagogues decrease the flow. 
Belladonna. Camphor. 

35. Haemostatics or Styptics. — Medicines which arrest hemor- 
rhage or flow of blood. 

Actual Cautery. Ergot. 

Astringents. Hot Applications. 

Cold Applications. Salt. 

Digitalis. Strychnine. 

36. Hydragogues. — Medicines which cause watery discharges 
from the bowels. See Cathartics. 

37. Hypnotics or Soporifics. — Medicines which produce sleep. 
Ammonium Bromide. Lithium Bromide. 
Amylene Hydrate. Methylal. 

Chloral. Paraldehyde. 

Cocaine. Potassium Bromide. 

Exalgine. Sodium Bromide. 

Hyoscine. Somnal. 

Hypnal. Trional. 



MATERIA MEDICA. 783 

38. Laxatives. — See Cathartics. 

39. Mydriatics. — Medicines which cause the pupils of the eyes 
to dilate. 

Atropin. Duboisine. 

Cocaine. 

40. Myotics. — Medicines which cause the pupils to contract. 
Eserine. Opium. 

Morphine. Physostigmine. 

41. Narcotics. — Powerful anodyne hypnotics or soporifics. 
Bromal Hydrate. Morphine. 

Cannabis Indica. Opium. 

42. Rubefacients. — Medicines which produce redness of the 
skin. 

Ammonia. Iodine. 

Arnica. Mustard. 

Camphor. Turpentine. 

Capsicum. Veratrine. 

43. Sialagogues. — Medicines which excite the flow of saliva. 
Acids. Mercury Compounds. 
Ether. Pilocarpus. 

Antisialagogues decrease the flow of saliva. 

Alkalies. Morphine. 

Atropin. Opium. 

44. Soporifics. — Hypnotics. 

45. Stomachics or Gastric Tonics. — Stimulants to the stomach 
which increase the appetite and aid digestion. 

Acids, Dilute. Liquor Sodas. 

Alcohol. Magnesia. 

Aloes. Nux Vomica. 

Antacids. Pancreatin. 

Aromatic Ammonia. Pepsin. 

Calumba. Potassium Bicarbonate. 

Cascarilla. Pulsatilla. 

Chamomile. Quassia. 

Eucalyptus. Quinine. 

Eupatorium. Rhubarb. 

Gentian. Sodium Bicarbonate. 

Hydrastis. Taraxacum. 

Lime Water. Vegetable Bitters. 

Liquor Potassse. 

46. Styptics. — Medicines which stop hemorrhage. 



;8 4 



MATERIA MEDICA. 



47. Sudorifics. — Medicines which produce perspiration. Dia- 
phoretics. 

48. Vermicides. — Medicines which kill intestinal worms. An- 
thelmintics. 

49. Vermifuges. — Medicines which expel intestinal worms. 

50. Vesicants. — Medicines which cause blisters. Epispastics. 

IMPORTANT OFFICIAL DRUGS RECOGNIZED BY THE 
PHARMACOPOEIA. 

Acacia. Gum Arabic. A gummy exuda- 
tion from Acacia Senegal (Willdenow) and 
other species of acacia. Abundant in west- 
ern Africa, north of the Senegal, in eastern 
Africa, Kordofan, and southern Nubia. The 
chief varieties of gum are : Turkey or Egyp- 
tian gum ; Barbary, Mogador or Morocco 
gum ; Senegal gum ; India gum ; and East 
African gum. Used as a demulcent in 
catarrhal affections and irritation of the 
throat ; a small piece of gum is allowed to 
dissolve slowly in the mouth. Used in phar- 
macy in making pills and troches, and to 
suspend insoluble substances in water. Mu- 
cilage of Acacia consists of half an ounce 
of gum in each fluidounce of mucilage. 
Must not be mixed with anything containing 
alcohol. Syrup of Acacia consists of 1 
ounce of gum in 11 fluidounces of syrup. 

Acetanilid. Made by the interaction of 
glacial acetic acid on aniline. An antipy- 
retic, analgesic, and (in small doses) a nerve 
sedative. Lowers the heart's action. Acts 
more slowly than antipyrine, and is rather 
more powerful. May cause in some patients 
deafness, ringing in the ears, weakness. In 
rare cases it has caused collapse and heart 
failure. Used also as a dressing for wounds 
and ulcers in powder or ointment. Dose 
from 5 to 8 grains. 

Acetate of Opium. See Vinegar of 
Opium. 

Acetate of Squill. See Vinegar of Squill. 

Acids. 

Acetic Acid. The most useful of acids 
to the apothecary ; obtained from the de- 
structive distillation of wood or by the oxi- 
dation of ethyl alcohol. Acetic acid consists 
of not less than 36 parts by weight of glacial 
acetic acid in 64 parts of water. Glacial 
acetic acid contains not less than 99 per 
cent by weight of absolute acetic acid and 
not more than 1 per cent of water. Dilute 
acetic acid contains not less than 4 per cent 
by weight of absolute acetic acid and not 
more than 96 per cent of water. Acetic 
acid is a mild caustic and is not used inter- 



nally. Dilute acetic acid is stimulant, astrin- 
gent, and refrigerant. It is used in baths 
as a toilet vinegar. When taken internally 
to increase the appetite and digestion, the 
dose of diluted acetic acid is from 20 to 40 
minims. 

Benzoic Acid (Acidum Benzoicum). An 
acid obtained by subliming benzoin. A 
stimulant expectorant in chronic bronchitis, 
in uric acid gravel, inflammation of the 
bladder ; is a powerful antiseptic, and is 
much used in the patented food preserva- 
tive mixtures ; is an ingredient of cosmetic 
washes. Dose in oill with soap, from 10 
to 30 grains. 

Boric Acid or Boracic Acid. A feeble 
acid obtained by the action of sulphuric 
acid upon borax. A soothing application to 
the mucous membranes, and nearly free from 
irritating properties. Used in conjunctivitis, 
aphthous sore mouth, ulceration of the 
mouth, and as an antiseptic wash for 
wounds. Used internally in some forms of 
inflammation of the bladder. Its safety as 
a food preservative is in doubt. Dose of 
boric acid, 5 to 10 grains. 

Camphoric Acid. Obtained by the oxida- 
tion of camphor. Used extensively in night 
sweats. Dose, from 5 to 15 grains. 

Chromic Acid (Chromium Trioxide). A 
red crystalline solid used as a caustic or 
escharotic. Not a true acid, but an acid 
anhydride. Rarely, if ever, used internally. 

Citric Acid. Present in the juice of 
many fruits, and originally obtained from the 
lemon and lime. Used as a substitute for 
lemonade and as an ingredient of efferves- 
cing salts. Dose, from 5 to 30 grains. 

Gallic Acid. Usually prepared from 
tannic acid by treatment with sulphuric acid. 
A less powerful astringent than tannic 
acid ; used in all cases of hemorrhage where 
the acid does not come into direct contact 
with the vessels. Also used in pyrosis, and 
in night sweats of phthisis or exhaustion. 
Dose, 5 to IS grains. 



MATERIA MEDICA. 



785 



Hydrochloric Acid. Contains 31.9 per 
cent of absolute hydrochloric acid. Ob- 
tained by the action of sulphuric acid on 
sodium chloride, common salt. Tonic, re- 
frigerant, and antiseptic. Used in low- 
fevers, phthisis, phosphatic deposits in 
urine, gastro-intestinal indigestion without 
diarrhoea. Dose, 5 to 10 minims in a wine- 
glass of water. 

Diluted Hydrochloric Acid. Contains 
10 per cent by weight of absolute hydro- 
chloric acid. Dose, from 10 to 30 minims 
in water. , 

Diluted Hydrocyanic or Prussic Acid. 
Contains not less than 2 per cent of abso- 
lute hydrocyanic acid. It may be prepared 
directly and quickly by treating silver cya- 
nide with diluted hydrochloric acid. One 
of the most deadly poisons known, and very 
rapid in its effects. A grain and a half of 
hydrocyanic acid produces death in an 
adult; and one or two drops upon the 
tongue will kill a large, strong dog in a few 
seconds. 

Lactic Acid. Made from milk by fer- 
mentation. A pale yellow and syrupy 
liquid, odorless, and of sour taste. Aids 
digestion and increases appetite. The diluted 
lactic acid is composed of 15 parts of Lactic 
Acid and 85 parts of Water. Dose of the 
diluted acid is from y 2 to . 2 teaspoonfuls. 
Dose of lactic acid is from 20 to 30 minims. 

Nitric Acid. Contains 68 per cent by 
weight of absolute nitric acid. Made by 
acting upon sodium nitrate with sulphuric 
acid. Its specific gravity is 1.403 at 77° F. 
Tonic, antiseptic, and astringent. Useful in 
intestinal indigestion. It is to be well 
diluted and taken through a glass tube to 
protect the teeth. Dose, from 5 to 10 
minims well diluted. It is applied exter- 
nally to ulcers in the strength of 12 minims 
to the pint of water. The strong nitric acid 
is a powerful escharotic. 

Diluted Nitric Acid. Contains 10 per 
cent by weight of absolute nitric acid. Dose 
of diluted nitric acid is from 20 to 40 min- 
ims well diluted. 

NlTROHYDROCHLORIC OR NlTROMURIATIC 

Acid. Known as Aqua regia by the early 
chemists. Made by mixing 18 parts of Nitric 
Acid with 82 parts of Hydrochloric Acid. 
It has the power of dissolving gold. Used 
in baths for hepatitis and biliary calculi ; in- 
ternally in chronic hepatic troubles, dyspep- 
sia with constipation. Taken through a 
glass tube, well diluted, and after meals. 
Dose, from 3 to 6 minims. 

Diluted Nitrohydrochloric Acid. Made 
from Nitric Acid, 4 parts ; Hydrochloric 



Acid, 18.2 parts; Water, 77.8 parts. Dose, 
from 10 to 20 minims. 

Oleic Acid. Obtained by purifying com- 
mercial oleic acid, a by-product from the 
manufacture of candles and glycerine. Spe- 
cific gravity, 0.895 ; insoluble in water ; 
soluble in alcohol, chloroform, benzine, fixed 
and volatile oils. Used chiefly for prepar- 
ing oleates and ointments. 

Phosphoric Acid. Consists of 85 per 
cent by weight of absolute orthophosphoric 
acid. Made by oxidizing phosphorus with 
nitric acid. Specific gravity, 1.707 at 77° F. 
Used in making phosphates and lactophos- 
phates. 

Diluted Phosphoric Acid. Composed of 
10 per cent by weight of absolute orthophos- 
phoric acid. Tonic and refrigerant ; used in 
dyspepsia, hysteria, diabetes, some forms of 
leucorrhea, and in low fevers. Dose, from 
20 minims to 1 fluidrachm well diluted. 

Salicylic Acid. Made by treating sodium 
phenol with carbon dioxide gas. Prevents 
putrefaction, but is condemned as a food 
preservative. A valuable remedy in rheum- 
atism and gout. Dose, from 5 to 30 grains. 

Stearic Acid. Obtained from tallow by 
the action of sulphuric acid. Used for mak- 
ing glycerine suppositories. 

Sulphuric Acid. Obtained by burning 
sulphur of pyrites and oxidizing the fumes 
of sulphurous acid gas. Specific gravity is 
1.840. A nuidounce weighs slightly more 
than 14 drachms. It is commonly called 
oil of vitriol. Rarely used as a caustic. 

Aromatic Sulphuric Acid (Acidum Sul- 
phuricum Aromaticum). Composed of Sul- 
phuric Acid, 111 parts; Tincture of Ginger, 
50 parts ; Oil of Cinnamon, 1 part ; and 
Alcohol to make 1,000 parts. Contains not 
less than 20 per cent by weight of sulphuric 
acid. Tonic, refrigerant, and astringent; 
used in diarrhoea, cholera, typhoid fever, 
night sweats, and in lead poisoning. Dose, 
from 5 to 15 minims well diluted and taken 
through a glass rod to protect the teeth. 
Sometimes given as sulphuric acid lemonade. 

Diluted Sulphuric Acid. Contains 10 
per cent of absolute sulphuric acid. Tonic, 
refrigerant, and astringent. Used in fevers 
as a tonic to increase the appetite and to 
aid digestion ; as an astringent in night 
sweats, hemorrhages, and diarrhoea. To be 
well diluted and taken through a glass tube 
to protect the teeth. Dose of the diluted 
acid, 10 to 30 minims. 

Sulphurous Acid. A liquid containing 
not less than 6 per cent by weight of sul- 
phur dioxide. A powerful antiseptic and 



786 



MATERIA MEDICA. 



germicide. As the fumes of burning sul- 
phur it is an important disinfectant. 

Tannic Acid. Obtained from nutgall. 
It is a solid, whitish, or yellowish powder, 
and is the chief constituent of vegetable 
astringents. Used in active hemorrhages, 
diarrhoea, relaxation of the uvula, chronic 
inflammation of the throat, aphthae, chapped 
nipples, ulcers, piles, and chilblains. Dose, 
from 3 to 10 grains. 

Tartaric Acid. Usually prepared from 
argol deposited on the inside of wine casks 
during fermentation. A cheap and valuable 
substitute for lemonade. Used in efferves- 
cing drinks. Dose, from 5 to 30 grains. 

Trichloracetic Acid. Made by oxidiz- 
ing hydrated chloral with nitric acid. An 
active caustic used in chronic inflammation 
of the nose, pharynx, and tonsils in a solu- 
tion of 1 in 1,000 or 1 in 2,000. Not used 
internally. 

Aconite. Monkshood or Wolfsbane. The 
dried root of Aconitum napellus (Linne), 
collected in the autumn and must contain not 
less than 0.5 per cent of aconitine. Aconite 
root comes from Europe or India. Both 
root and leaves are used, though the U. S. 
Pharmacopoeia does not recognize the leaves. 
In the formation of acute inflammation, 
such as quinsy, pneumonia, pleurisy, rheu- 
matism, erysipelas, aconite is of great value. 
This remedy is extensively used by all phy- 
sicians. For breaking up colds and fevers 
it probably has no superior. It is antipy- 
retic, diaphoretic, diuretic, much used in 
acute throat affections and inflammation of 
the lungs and respiratory passages. Dose 
of aconite root, Y 2 to 1 grain. Dose of the 
fluidextract, from ^ to 1 minim, but must 
be used with great caution, beginning with 
the smallest dose ; of tincture of aconite, 
from 3 to 10 minims. In the revised phar- 
macopoeia of 1905, the tincture of aconite 
has been greatly reduced in strength from 
35 per cent to 10 per cent. The dose is, 
therefore, about three times as great as 
formerly. 

Alcohol ( Spirit of wine or rectified 
spirit). The result of the fermentation of 
many vegetables. A wonderful preservative 
agent. Used in the preparation of tinctures 
of substances containing a large proportion 
of resinous properties. Good whiskey, which 
contains 50 per cent of alcohol, is often used 
instead of diluted alcohol. Valuable as a 
heart stimulant in cases of shock, collapse, 
and heart failure. Absolute alcohol con- 
tains not more than 1 per cent of water 
and has a specific gravity of 0.797 at 60° F. 
Commercial alcohol contains 91 per cent of 
absolute alcohol and 9 per cent of water 



by weight; 92.3 per cent of ethyl alcohol 
and 7.77 per cent of water by volume. 
Dilute alcohol contains 41 per cent by 
weight of absolute alcohol. Methyl alcohol, 
methylated spirit, is "wood alcohol" and 
is poisonous. Rectified spirit contains 84 
per cent of absolute alcohol. Proof spirit 
is diluted alcohol (see above). Ethyl alco- 
hol is the ordinary alcohol, sometimes called 
ethyl hydrate and grain spirit. Amyl alco- 
hol, amyl hydrate, potato spirit, or fusel 
oil, is derived by continuing the distillation 
after the pure spirit (ethyl alcohol) has 
ceased to be given off. Denatured alcohol 
is ethyl alcohol mixed with some nauseous 
substance to render it unfit for drinking. 

Almond Oil. A demulcent and useful 
ingredient of prescriptions and preparations, 
especially to conceal the taste of cod-liver 
oil and castor oil. The bitter almond oil 
contains from 2 to 4 per cent of hydro- 
cyanic acid, and is used like the latter. 
Dose, % of a minim — about ^ of a drop. 
Almond oil is obtained only from the bitter 
almond. Another oil known as the Expressed 
Oil of Almonds is made from either bitter 
or sweet almonds. It is used as an emul- 
sion in pulmonary affections with cough. 

Aloes. An excellent purgative, does not 
produce watery stools, nor create wind in 
the bowels, rarely disagrees with the stom- 
ach. In small doses assists digestion. Often 
used in cases of habitual costiveness in 
connection with indigestion. Aloes act prin- 
cipally on the lower intestines, and will irri- 
tate if given too frequently or in too large 
doses. Should not be used in cases of piles, 
except in very small doses, nor when there 
is inflammation in the bowels, and should 
be carefully avoided by females who are 
subject to immoderate flowing of the 
menses, and carefully avoided during preg- 
nancy. It is emmenagogue and anthelmin- 
tic. Dose of the extract or inspissated 
juice from 2 to 10 grains; average dose, 
4 grains. Tincture of Aloes is a solution of 
1 in 10 or a 10 per cent solution, the dose 
of which is from ^ to 1 drachm ; average 
dose, 30 minims. The dose of the tincture 
of aloes and myrrh is the same as that of 
the tincture of aloes. Aloes Pill, known as 
Pill of Barbadoes Aloes, contains 2.01 grains 
of aloes, and the dose is two or three pills 
at bedtime. The pill of aloes and asa- 
foetida was not retained in the 8th Revision 
of the U. S. P. The aloes and iron pill 
consists of Aloes, 1 grain ; Sulphate of Iron, 
1 grain ; Aromatic Powder, 1 grain ; made 
into a mass with Confection of Roses. Of 
value as a mild purgative, tonic, and blood 
builder. The pills of Aloes and Mastic 
(known as Lady Webster Pills) contain 



MATERIA MEDICA. 



787 



Aloes, 2 grains; Mastic, .62 grain, and Red 
Rose, .46 grain. The pill of Aloes and 
Myrrh contains about 2 grains of Aloes ; 
Myrrh, .93 grain; it is known as Rufus's 
Pill. 

Aloin. The active principle of aloes. 
Used in pills as a purgative. Dose, % grain. 

Alum. An astringent, styptic ; in 1 drachm 
doses an emetic ; in large doses a purgative. 
Dried alum is ordinary alum deprived of its 
water by heat. From 1 to 4 drachms of alum 
in 5 or 6 ounces of alcohol is an excellent 
wash to harden the skin and to prevent bed- 
sores. Useful in checking the flow of blood 
from the nose, gums after extraction of 
teeth, slight wounds, and sometimes in cases 
of piles. In nosebleed, powder and blow 
into the nostrils through a quill. A solu- 
tion of alum is useful in chronic discharges 
from the nose, ear, and female genital or- 
gans. In these cases use a teaspoonful 
alum to a pint of water. A gargle of alum 
water is beneficial in many cases of sore 
throat, especially when the parts are re- 
laxed and "palate down." Burnt alum will 
remove proud flesh. Alum is sometimes 
used internally for diarrhoea and dysentery. 
Two or three grains dissolved in aromatic 
syrup, taken three or four times daily, will 
often do much good in the later stages of 
whooping cough. Alum is an effective 
emetic in spasmodic croup. Dose, teaspoon- 
ful of powdered alum mixed w r ith same 
amount of molasses and water ; give one 
third of this quantity every three to five 
minutes until the desired result is produced. 

Ammonia. A gas with a pungent odor 
and strongly alkaline properties. The gas 
dissolved in water in a 10 per cent propor- 
tion forms the ordinary ammonia or liquor 
of ammonia used in medicine and for house- 
hold cleansing purposes. The stronger solu- 
tion (known as Aqua Ammonia Fortior and 
used externally only) contains 28 per cent 
of the gas. Ammonia compounds are ant- 
acid, gastric, and cardiac stimulants, and are 
used in headache, hysteria, bronchitis, and 
other lung affections. Dose of ammonia 
water, from 5 minims to y 2 drachm. Used 
externally as a counterirritant ; also in 
stings and bites of insects. 

Ammoniac. A gum in the form of tears 
or cakes derived from the Dorema ammo- 
niacum of Persia. It is a stimulant expec- 
torant of value in bronchitis and asthma. 
Dose, 10 to 30 grains. 

Ammonia Liniment. Composed of Am- 
monia Water, 35 parts; Cottonseed Oil, 57 
parts ; Alcohol, 5 parts ; and Oleic Acid, 3 
parts. An excellent rubefacient for inflam- 



matory conditions of the throat ; catarrhal 
and chest affections of children ; and in 
rheumatic pains. Applied by rubbing and 
on flannel. 

Ammoniated Mercury. White Precipi- 
tate. Contains not less than 78 per cent or 
more than 80 per cent of metallic mercury. 
Used in ointment in eruptions of the skin, 
such as psora, porrigo, and herpes. 

Ammonium Benzoate. Contains not less 
than 98 per cent of pure ammonium ben- 
zoate. Made from benzoic acid and water 
of ammonia. Used in urinary derangements 
and gouty affections. A diuretic. Dose, 
from 10 to 30 grains. 

Ammonium Carbonate. Should yield not 
less than 31.58 per cent of ammonia gas. 
Made by subliming ammonium chloride 
with chalk. A powerful heart stimulant ; 
largely used in pneumonia, bronchitis, and 
in the last stages of phthisis. With strong 
ammonia and oil of lavender it forms 
smelling salts. Dose, 5 to 10 grains. 

Ammonium Chloride. Sal Ammoniac or 
Muriate of Ammonia. Obtained from the 
gas liquor of gas works, and also from the 
destructive distillation of bone. A stimu- 
lant expectorant in acute and chronic bron- 
chitis, and in catarrhal pneumonia. Dose, 
from 5 to 10 grains. 

Ammonium Iodide. Used in chronic 
rheumatism, incipient phthisis, and scrofu- 
lous enlargements. Dose, 3 to 5 grains. 

Ammonium Salicylate. A salt new to 
the XT. S. P. The best of the salicylates for 
use in rheumatism, being less nauseous and 
depressing than others. Dose, 10 to 20 
grains. 

Ammonium Valerianate. Useful in mild 
nervous affections, hysteria, chorea, and 
neuralgia. Dose, 2 to 10 grains. 

Amyl Nitrite. An ethereal liquid, hav- 
ing a fruity odor and pungent taste. In- 
creases the heart's action ; dilates the cap- 
illaries, lowers the blood pressure ; prevents 
spasms, especially in epilepsy, neuralgia of 
the heart, and malarial chills. It is an 
antidote in poisoning by chloroform. Dose, 
from 3 to 5 drops placed on a handkerchief 
and inhaled. From 6 to 8 drops may be 
given by the mouth on sugar. 

Anise. A carminative, derived from the 
Pimpinella anisutn. Dose, from 10 to 20 
grains ; dose of the oil of anise, from 2 to 
5 drops ; of anise water, from 1 to 4 grains : 
of the spirit of anise, from 1 to 2 drachms. 
Used to liquefy the bronchial secretions, 
hence a useful ingredient of cough mixtures. 
It is also a mild heart stimulant. 



788 



MATERIA MEDICA. 



Antimony and Potassium Tartrate. 
Tartar Emetic. In small doses of 1-12 of 
a grain it is diaphoretic and expectorant, 
often of great service in the earlier stages 
of bronchitis. In doses of ^ grain it is 
emetic. In larger doses it is poisonous. 

Antimony, Wine of. Composed of Tar- 
tar Emetic, 4 parts; Boiling Water, 65 parts; 
Alcohol, 175 parts; and White Wine to 
make 1,000 parts. It thus contains 1.8 
grains of tartar emetic to the fiuidounce. 
The wine of antimony makes it possible to 
easily administer small doses of tartar 
emetic with certainty. Dose, as an expec- 
torant or diaphoretic, 10 to 30 minims; as 
an emetic for children, from 30 minims to 
a fluidrachm, repeated every 15 minutes 
until effective. 

Antipyrine. Phenyldimethylpyrazolon ; 
in the British Pharmacopoeia it is known as 
Phenazone. Made by condensing phenylhy- 
drazine with aceto-acetic ether and methyl- 
izing the product. Given in fevers as a 
very powerful and effective antipyretic, re- 
ducing the fever in half an hour ; also an 
analgesic in migraine, rheumatism, and neu- 
ritis. It is also sedative, diuretic, and 
sligthly haemostatic. Its after effects are 
decided depression, and, often, a weakened 
pulse. Dose, from 5 to 15 grains; average 
dose, 7 J/2 grains in wine, iced brandy, and 
water. A treacherous drug. 

Apocynum. Canadian Hemp, Dogsbane, 
Black Indian Hemp. The dried rhizome of 
Apocynum cannabinum (Linne). Cardiac 
stimulant, diuretic, and expectorant. In large 
doses an emetic and drastic purgative. Given 
in decoction and infusion. The decoction 
of half an ounce of the root in \ l / 2 pints of 
boiling water is given in doses of from 1 to 
2 fluidounces at intervals. Dose of the 
fluidextract from 5 to 10 minims; as an 
emetic, 15 to 20 minims. 

Apomorphine Hydrochloride. Apomor- 
phine is an alkaloid prepared from morphine 
by the abstraction of 1 molecule of water. 
From 1-15 to 1-10 of a grain injected under 
the skin of an adult provokes free vomiting 
in from 5 to 20 minutes. As an expectorant 
the dose is from 1-20 to 1-16 of a grain; as 
an emetic, by the mouth, from 1-10 to % of 
a grain. Under no circumstances is more 
than Yi, of a grain ever given. 

Aquae (Waters). Medicated waters are 
all preparations holding volatile or gaseous 
substances in solution. 

Aqua Ammoniae or Ammonia Water. 
Contains 10 per cent by weight of gaseous 
ammonia dissolved in water. It is stimu- 
lant, irritant, or caustic, according to 



strength. A valuable remedy in sudden 
syncope. 

Aqua Ammoniae Fortior or Stronger 
Ammonia Water. Contains 28 per cent by 
weight of gaseous ammonia dissolved in 
water. 

Aqua Amygdalae Amarae or Bitter 
Almond Water. Oil of Bitter Almonds 
dissolved in water in the proportion of 1 in 
1,000. Dose, 1 fluidrachm. 

Aqua Anisi or Anise Water. Oil of 
Anise dissolved in water in the proportion 
of 1 in 1,000. Used as a vehicle. 

Aqua Aurantii Florum or Orange 
Flower Water. Stronger Orange Flower 
Water and Distilled Water, equal parts. 
Used as a vehicle and to flavor syrups and 
elixirs. 

Aqua Aurantii Florum Fortior or 
Stronger Orange Flower Water. A satu- 
rated solution of the volatile oil of fresh 
orange flowers. 

Aqua Camphorae or Camphor Water. 
Eight grammes of Camphor, 8 cubic centi- 
meters of Alcohol, 8 grammes of Purified 
Talc, and Water to make 1,000 cubic centi- 
meters. Dose, ^ to 1 fiuidounce. 

Aqua Chloroformi or Chloroform 
Water. One half per cent of chloroform 
in water. An excellent vehicle. Dose, y 2 
to 2 fluidrachms. 

Aqua Cinnamomi or Cinnamon Water. 
Oil of Cinnamon, 2 cubic centimeters ; Puri- 
fied Talc, 15 grammes; Distilled Water to 
make 1,000 cubic centimeters. A vehicle. 

Aqua Creosoti or Creosote Water. One 
per cent of creosote in water, or about 4.8 
minims of creosote to the fiuidounce. A 
gargle, lotion, or to correct foul odors. 
Dose, 1 to 4 fluidrachms. 

Aqua Foeniculi or Fennel Water. Two 
cubic centimeters of Oil of Fennel in 
1,000 cubic centimeters. A mild aromatic 
serving as a vehicle for other medicines. 

Aqua Hamamelidis or Hamamelis Water 
or Witch Hazel Water. Made from 
Witch Hazel Bark, Alcohol, and Water. 

Aqua Hydrogenii Dioxidi or Solution 
of Hydrogen Dioxide or Peroxide. Con- 
tains about 3 per cent by weight of Hydro- 
gen Dioxide in water. A powerful antisep- 
tic, deodorant, and cleanser of putrid cavi- 
ties, abscesses, and infected wounds. Dose, 
1 fluidrachm (U. S. P.). 

Aqua Menthae Piperitae or Peppermint 
Water. Two cubic centimeters of Oil of 
Peppermint; 15 grammes of Purified Talc; 
1,000 cubic centimeters of water. A vehicle. 



MATERIA MEDICA. 



789 



Aqua Menthae Viridis or Spearmint 
Water. Two cubic centimeters of Oil of 
Spearmint; 15 grammes of Purified Talc; 
1,000 cubic centimeters of Water. The 
mint waters and cinnamon water are the 
most frequently employed of all vehicles. 

Aqua Rosae or Rose Water. Stronger 
Rose Water and Distilled Water in equal 
parts. Used in lotions on account of its 
agreeable odor and the absence of irritating 
effects. 

Aqua Rosae Fortior or Stronger Rose 
Water. A saturated solution of the vola- 
tile oil of rose petals in water. Used in 
making Rose Water. 

Argenti Cyanidum or Silver Cyanide. 
Used officially in making Hydrocyanic Acid. 

Argenti Nitras or Silver Nitrate or 
Lunar Caustic. In a pure state an eschar- 
otic. An aqueous solution, 20 or 30 grains 
to the ounce, is used in inflammations of 
the mucous membranes ; for an eye lotion in 
the strength of 1 or 2 grains to the ounce. 
It is an alterative in certain nervous affec- 
tions. Dose, yi to y 2 grain. 

Argenti Nitras Fusus or Moulded Sil- 
ver Nitrate or Lunar Caustic. In the 
form of moulded pencils of silver nitrate 
toughened by the action of Hydrochloric 
Acid. For external use as a stimulant, vesi- 
cant, or escharotic. To apply to warts, ex- 
crescences, ulcers, etc. 

Argenti Nitras Mitigatus or Mitigated 
Silver Nitrate. One part of Silver Nitrate 
fused with 2 parts of Potassium Nitrate. 
Less energetic in outward applications than 
the fused nitrate. 

Argenti Oxidum or Silver Oxide. A 
substitute for silver nitrate, as it is not 
escharotic and does not stain the skin to 
such a degree. Dose, 1 grain. 

Arnica. The dried flower heads of 
Arnica montana (Linne) ; while the flowers, 
root, and leaves are used, the flowers only 
are official. Useful in sprains, bruises, etc. ; 
for this purpose a tincture of the flowers 
has great repute as a household liniment. 
When given internally, the tincture is given 
in doses of from 5 to 10 drops repeated 
every two hours. The tincture of the U. S. 
P. is» twice as strong as that of the British 
Pharmacopoeia. The U. S. tincture is made 
from the flowers ; that of the Br. P. is made 
from the rhizome. 

Aromatic Powder (Pulvis Aromaticus). 
Composed of Cinnamon and Ginger, of each 
35 parts; Cardamom and Nutmeg, of each 15 
parts. Stimulant and carminative in doses 
of from 10 to 30 grains. It also forms an 



excellent spice plaster to be placed over the 
stomach in cases of nausea. 

Aromatic Spirit of Ammonia (Spiritus 
Ammoniae Aromaticus) . Composed of Ammo- 
nium Carbonate, 34 parts ; Ammonia Water, 
90 parts; Oil of Lemon, 10 parts; Oil of 
Lavender Flowers, 1 part ; Oil of Nutmeg, 
1 part ; Alcohol, 700 parts ; and Water to 
make 1,000 parts. Its specific gravity ;'s 
about 0.900 at 25° C. or 77° F. A stimu- 
lant antacid in sick headache, a stomachic, 
and prevents nausea. Dose, from 30 minims 
to a fluidrachm well diluted. 

Arsenate of Soda (Sodii Arsenas). Tonic, 
alterative, improves nutrition. Useful in 
anaemia, chlorosis, scrofula, St. Vitus' dance 
or chorea, malaria, eczema, and chronic 
skin diseases. Dose of the crystallized salt, 
1-10 of a grain. 

Arsenic Trioxide or Arsenous Acid 
(Arseni Trioxidum). Called also Arsenous 
Anhydride, Arsenous Oxide, and White 
Arsenic. In concentrated form and as a 
local application it is a violent and some- 
what dangerous irritant and escharotic. In 
medicinal doses internally it is alterative; 
affects nutrition favorably ; useful in nerv- 
ous debility, chorea or St. Vitus' dance, 
chronic malaria ; stomachic, increases the 
appetite, improves digestion ; in large doses 
it is a violent poison. Dose of arsenic tri- 
oxide, l-50th to l-20th of a grain. 

Asafoetida. A gum resin obtained from 
the root of Ferula foetida found in Persia 
and Afghanistan. A powerful stimulant 
antispasmodic, expectorant, and feeble laxa- 
tive. Used in hysteria, hypochondriasis, 
convulsions, spasms of stomach and bowels, 
whooping cough, asthma, croup, measles, 
and catarrh. Given in pill in doses of from 
5 to 10 grains. The tincture of asafoetida 
contains 20 per cent of asafoetida. Dose of 
the tincture, from 30 minims to a fluidrachm. 

Aspidium. Male fern. The dried rhi- 
zome of Dryopteris iilix mas. Used among 
the ancients as a vermifuge. The powdered 
root contains an oleoresin that is a very effi- 
cient agent against tapeworm. Large doses 
are poisonous. For the expulsion of tape- 
worm, the patient lives on bread and a little 
milk for one day preceding a dose of from 
^ to 1 fluidrachm of the oleoresin taken 
in the morning. Dose of the powdered root, 
from 1 to 2 drachms. 

Atropine. An alkaloid obtained from the 
Atropa belladonna and from other plants of 
the family of Solanaceae. A violent poison, 
to be used with the utmost caution. Useful 
in spasmodic diseases, whooping cough, 
asthma, narcotic poisonings, shock, and for 



790 



MATERIA MEDICA. 



dilating the pupil of the eye. Dose of 
atropine from l-200th to l-100th of a grain. 

Atropine Sulphate (Atropinae Sulphas). 
Made by neutralizing atropine with diluted 
sulphuric acid. Uses the same as those of 
atropine and belladonna. A 1 per cent solu- 
tion of atropine sulphate applied to the ex- 
posed pulp of a tooth is said to be an in- 
stantaneous cure for the toothache. Used 
largely in dentistry. Dose, from l-200th to 
l-100th of a grain. 

Aurantii Amari Cortex or Bitter Or- 
ange Peel. The dried rind of the unripe 
fruit of Citrus vulgaris. 

Aurantii Dulcis Cortex or Sweet Or- 
ange Peel. The recently separated rind of 
the Citrus aurantii. Bitter orange peel is a 
mild tonic, carminative, and stomachic. 
The sweet is only aromatic. They are added 
to preparations of the vegetable bitters, gen- 
tian, quassia, calumba, and Peruvian bark. 

Balsam of Peru {Balsa mum Peruvianum). 
Obtained from the Toluifera pereirae, a 
tree found in Central America, especially 
in San Salvador (not in Peru). A warm, 
stimulating stomachic, expectorant used in 
chronic catarrhs, asthma, phthisis ; applied 
externally to chronic indolent ulcers. It is 
diffused in water with sugar and yolk of 
egg. In prescriptions it is suspended by 
mucilage of acacia. Dose, from 5 to 15 
minims. 

Balsam of Tolu {Balsamum Tolutanum). 
Obtained from the Toluifera balsamum by 
incisions in the trunk of the tree. It is a 
feeble stimulant expectorant of agreeable 
flavor and much used as the basis of cough 
mixtures. Given in emulsion in doses of 
from 10 to 30 grains. See Tincture of Tolu. 

Belladonna Leaves {Belladonna Folia). 
The dried leaves of Atropa belladonna. 

Belladonna Root {Belladonna Radix). 
The dried root of Atropa belladonna. Bella- 
donna or Deadly Nightshade is a native of 
Europe and is cultivated in the United 
States. All parts of it are medicinal. Its 
uses are the same as those of atropine 
(which see). Given as extract in the dose 
of 1 grain. See Tincture of Belladonna 
and Extract of Belladonna. 

Basham's Mixture. Solution of iron 
and acetate of ammonia {Liquor Ferri et 
Ammonii Acetatis). An active chalybeate 
and astringent, much used in chronic Bright's 
disease. Dose from y^ to x /i fluidounce of 
the freshly-made preparation. It is double 
the strength of the former preparation. 
Contains 4 per cent of the tincture of ferric 
chloride. 

Basilicon Ointment. Rosin Cerate (Ora- 



tum Resinae). Composed of Resin, 35 
parts; Yellow Wax, 15 parts; and Lard, 50 
parts. Much used as an application to blis- 
tered surfaces, indolent ulcers, burns, scalds, 
and chilblains, to which it is gently stimu- 
lating. Especially effective on ulcers fol- 
lowing burns. 

Benzaldehyde. An aldehyde derived 
from the oil of bitter almonds. It is the 
artificial oil of bitter almonds. Used as a 
flavoring agent. It contains no hydrocyanic 
acid. 

Benzoin {Benzoinum). A balsamic resin 
obtained from the Styrax benzoin found in 
Sumatra, Java, Borneo, and adjacent islands. 
A stimulant expectorant used in lung affec- 
tions ; in bronchitis by inhalation. Dose 
from 15 to 30 grains. Used chiefly to make 
benzoic acid. In inhalation the benzoin is 
dissolved in boiling water and the steam is 
inhaled. See Tincture of Benzoin. 

Benzosulphinide Saccharine {Benzosul- 
phinidum). An artificial sweetening sub- 
stance known popularly as "saccharine" used 
as a substitute for sugar in diabetes, obesity. 
Dose from 3 to 5 grains. 

Berberis. California Barberry or Holly- 
Leaf Barberry. The roots and rhizome of 
the Berberis aquifolium, found on both 
sides of the Rockies. Alterative, laxative, 
tonic, and diuretic. Used in scrofula, 
chronic skin diseases, malarial and other 
fevers, and chronic uterine diseases. Dose, 
from 20 to 30 grains. See Fluidextract of 
Berberis. 

Betanaphthol. A phenol occurring in 
coal tar, but made from naphthalene. One 
of the best agencies for checking fermenta- 
tive processes in the intestines. Dose, from 
2 to 5 grains in capsules. 

Bismuth Citrate {Bismuth Citras). Con- 
tains not less than 56 per cent and not more 
than 58 per cent of bismuth oxide. Used 
only for making bismuth and ammonium 
citrate. 

Bismuth and Ammonium Citrate {Bis- 
muthi et Ammonii Citras). More rapid, 
more astringent, and more irritant than the 
other preparations of bismuth. Dose, from 
1 to 3 grains. 

Bismuth Oxide. Similar in effects to 
bismuth subnitrate. Dose, from 10 to 30 
grains. 

Bismuth Subcarbonate. Similar in ef- 
fects to bismuth subnitrate. Dose, 10 to 
30 grains. 

Bismuth Subgallate. Similar to the 
subnitrate, except that it is, perhaps, more 



MATERIA MEDICA. 



791 



astringent and therefore more useful in 
diarrhoea. Dose, 7 to 30 grains. 

Bismuth Subnitrate. Very useful in 
subacute gastritis, gastralgia, pyrosis, and 
other stomach diseases, irritation of the in- 
testines, diarrhoea, and dysentery. Dose, 
from 5 to 30 grains. 

Bromoform. A liquid resembling chloro- 
form, especially useful in whooping cough, 
given in extremely small do^es, as the drug 
is highly poisonous. Dose, from 1 to 5 
drops in capsules, or on sugar, or in emul- 
sions. 

Buchu. The dried leaves of Barosma 
betulina, found in Africa. Very useful in 
diseases of the urinary organs, especially 
in gravel, chronic catarrh of the bladder, 
irritation of the bladder, retention or incon- 
tinence of urine. Not to be used when the 
inflammation is severe. Dose, 1 drachm. 
See Infusion of Buchu, Tincture of Buchu, 
and Fluidextract of Buchu. 

Caffeine (Caffeina). Obtained from the 
dried leaves of the tea plant, Thea sinensis, 
or from those of the coffee plant, Coffea 
arabica. The amount of caffeine in several 
kinds of coffee varies from 0.6 to 2.2 per 
cent. It is a cerebral and cardiac stimu- 
lant, and diuretic. Used in somnolence, 
nervous headache, narcotic poisoning, heart 
failure, cardiac dropsies, chronic Bright's 
disease, and sudden collapse. Dose, 1 to 5 
grains. 

Caffeine Citrate. One of the best forms 
in which caffeine can be used internally. 
Dose, from 3 to 8 grains. The effervescent 
citrate is given in doses of a teaspoonful 
in water. 

Calamus. The dried rhizome of the 
Acorus calamus or Sweet Flag, found abun- 
dantly in damp places in the United States. 
It has a pungent, aromatic taste ; used to 
relieve pain or uneasiness of the stomach 
or bowels. Also much used in "bitters." 
Dose of the root, from 20 to 60 grains. 
Made in an infusion of the strength of 1 
ounce to 1 pint of boiling water, it may be 
taken in doses of from 1 to 2 wineglassfuls. 
See Fluidextract of Calamus. 

Calcium Chloride. Made by treating 
chalk or marble with hydrochloric acid, 
evaporating the residue to dryness, and 
heating to redness. Useful in cases of in- 
ternal bleeding. Dose, 5 grains three times 
a day. 

Calumba. The dried root of Jateorrhiza 
palmata, found in Africa. A mild, bitter 
tonic, without astringency ; used in derange- 
ments of the digestive organs. Dose of the 
powder, from 10 to 30 grains. 



Camphor. Obtained from the Cinna- 
momum camphora, a large evergreen tree 
found in China, Japan, and other parts of 
eastern Asia, and in cultivation in many 
subtropical countries. An antispasmodic in 
nervous headaches and hysterical conditions ; 
a cardiac stimulant in heart failure, typhoid 
fever, pneumonia ; allays intestinal pain in 
diarrhoea ; a local application in rheumatism, 
sprains, and bruises. Dose, from 2 to 5 
grains. Large doses are poisonous ; there 
is no known antidote for its effects. Mono- 
bromated camphor is a substitution product 
of camphor, and has been used as a nerve 
sedative. 

Camphor Water {Aqua Camphorae). Cam- 
phor, 8 parts ; Alcohol, 8 parts ; Purified 
Talc, 15 parts; Water, to make 1,000 parts. 
Used as a vehicle for administering other 
medicines. Dose, from x / 2 to 1 fiuidounce. 

Cantharis or Blistering Flies or Span- 
ish Flies. The beetle {Cantharis vesica- 
toria) thoroughly dried ; most abundant in 
Spain, Italy, southern France, and Russia. 
Used in scaly cutaneous diseases, chronic 
eczema. They are most frequently used as 
blistering agents. 

Capsicum or Cayenne Pepper. The ripe 
fruit of the Capsicum fastigiatum, cultivated 
everywhere. A powerful local stimulant ; 
used as a stomach tonic except in ordinary 
cases of gastric catarrh, also used in cases 
of neurasthenia. Externally it is a rube- 
facient. Dose of the powder, from 1 to 10 
grains in a pill. See Tincture of Capsicum. 

Cardamom. The dried fruit of Elettaria 
repens of Malabar. It is aromatic, carmina- 
tive, stomachic, and used as a constituent 
of "bitters." Valuable to prevent purga- 
tives from griping. Dose, from 15 to 30 
grains. See Tincture of Cardamom. 

Caraway. The dried fruit of Carum 
carvi, found everywhere. A pleasant sto- 
machic and carminative, useful in flatulent 
colic and as a corrective of other medicines. 
Dose, 15 to 30 grains. 

Cassia, Purging. The dried fruit of the 
Cassia fistula, a large, handsome tree, called 
Golden Shower in India. Found also in 
Cochin China, Egypt, Nubia, West Indies, 
and parts of tropical America. Given in 
small doses in habitual constipation ; in 
larger doses it causes nausea, flatulence, and 
griping. Dose of the pulp, 1 or 2 drachms 
as a laxative. 

Cerates. Substances consisting of oil or 
lard mixed with wax, spermaceti, or resin, 
to which medicinal agents are frequently 
added. In consistence, cerates are midway 
between ointments and plasters. They are 



792 



MATERIA MEDICA. 



thin enough to spread easily upon muslin, 
but" firm enough to neither melt nor run 
when applied to the body. 

Simple Cerate. White Wax, 30 parts; 
White Petrolatum, 20 parts; Benzoinated 
Lard, 50 parts. Used for dressing blisters, 
wounds, etc., to prevent contact with the 
air, to keep the parts moist, and to prevent 
irritation. 

Camphor Cerate. Camphor Liniment, 
10 parts; White Wax, 35 parts; White 
Petrolatum, 15 parts; Benzoinated Lard, 40 
parts. A slightly stimulating dressing con- 
taining 2 per cent of camphor. 

Cantharides or Blistering Cerate. 
Cantharides (Spanish Flies), 32 parts; 
Liquid Petrolatum, 15 parts; Yellow Wax, 
18 parts; Rosin, 18 parts; Lard, 17 parts. 
It is best spread upon thin leather, though 
linen or even paper will do. The skin is 
first moistened with warm vinegar. To 
obtain the full blistering effects upon adults, 
it should remain for 8 hours and on the 
scalp for 12 hours. Upon delicate persons, 
or when it is desired to produce a quickly 
healing blister, it should be removed as soon 
as marked redness of the skin is observed — ■ 
perhaps in 5 hours or less. From 2 to 4 
hours is long enough in the case of children. 
Follow the cerate with a flaxseed or other 
soft poultice until the blister forms. The 
blister should be opened at the lowest or 
depending part. To heal quickly apply 
Goulard's Cerate freely. 

Cerate of Lead Subacetate or Goulard's 
Cerate. Solution of Lead Subacetate, 20 
parts ; Wool-fat, 20 parts ; Paraffine, 20 parts ; 
White Petrolatum, 38 parts ; Camphor, 2 
parts. Used after blisters, in burns, scalds, 
chilblains, and in all cases of acute, active 
inflammation of the skin. 

Rosin Cerate or Basilicon Ointment. 
Rosin, 35 parts; Yellow Wax, 15 parts; 
Lard, 50 parts. Used in blisters, indolent 
ulcers, burns, scalds, and chilblains. 

Compound Rosin Cerate or Deshler's 
Salve. Rosin, 22^ parts; Yellow Wax, 
22^ parts; Prepared Suet, 30 parts; Tur- 
pentine, 11 J^ parts; Linseed Oil, 13 y 2 parts. 
Used the same as Rosin Cerate. 

Cerium Oxalate. A mixture of such 
rare earths as cerium, didymium, and lan- 
thanum. Used as a remedy for vomiting 
in pregnancy, and in the gastric disturb- 
ances which attend phthisis, uterine disor- 
der, hysteria, dyspepsia, and pyrosis. Dose, 
1 grain, repeated three times a day, as a 
pill or in water. 

Cetaceum or Spermaceti. A fatty solid 
substance obtained from the head of the 



sperm whale (Physeter macro cephalus). The 
quantity obtained from one sperm whale 
will fill more than 12 barrels. Used in mak- 
ing ointments. 

Chalk, Prepared (Creta Preparata). Used 
principally in medicine for the purpose of 
checking purging, from acidity of the stom- 
ach and bowels. It is mild in action and 
suited to children. Dose, from 5 to 20 
grains. Compound Chalk Powder is made of 
Prepared Chalk, 30 parts; Acacia, 20 parts; 
and Sugar, 50 parts. Dose, from 5 grains 
to 1 drachm. Chalk mixture consists of 
Compound Chalk Powder, 20 parts ; Cinna- 
mon Water, 40 parts ; Water, 40 parts. It 
is much used in diarrhoea. Dose, x / 2 ounce. 

Charcoal (Carbo Ligni). Wood-charcoal 
finely powdered and taken into the stomach, 
absorbs the gases, and is of great value for 
dyspepsia, with fetid breath, characterized 
by flatulence. Dose. 5 to 10 grains, often 
given with bismuth and pepsin in the form 
of lozenges. The powder is frequently 
mixed with flaxseed poultices and applied 
to gangrenous sores with cleansing results. 
Foul water may be rendered pure by filter- 
ing through charcoal. Charcoal poultice is 
made as follows : Wood-charcoal, 1 part ; 
Bread Crumbs, 1 part ; Linseed Meal, 3 parts ; 
Boiling Water, 20 parts. Charcoal is con- 
veniently prepared in tablets for internal 
use. 

Charta Sinapis or Mustard Paper. 
Papers to which Black Mustard powder is 
applied and caused to adhere by a solution 
of rubber in Carbon Bisulphide. Used in- 
stead of the mustard poultice. Can rarely 
be borne more than 10 or 15 minutes. 

Chimaphila. Pipsissewa, Prince's Pine. 
A diuretic and astringent tonic. The leaves 
when bruised are used as a rubefacient. 
Valuable in dropsy, kidney diseases, and 
affections of the urinary passages. Dose of 
the decoction, from 1 to 3 ounces. The 
best preparation is the fluidextract (which 
see). 

Chloral Hydrate (Chloralum Hydratum). 
Hydrated Chloral. It quiets pain and pro- 
duces sleep lasting about three hours. A 
powerful hypnotic, antispasmodic, and de- 
pressant to the nervous centers. A limited 
anaesthetic. Used in fevers, in St. Vitus' 
dance, convulsions, and delirium tremens, 
and in such cases is superior to opium. 
Very great caution is to be exercised in its 
use. Dose, from 5 to 20 grains. 

Chloroform. Prepared by mixing and 
heating chlorinated lime, slaked lime, ethylic 
alcohol, and water. In small internal doses 
it is antispasmodic and carminative. Applied 
externally as a constituent of liniments. 



MATERIA MEDICA. 



793 



Inhaled with air a valuable general anaes- 
thetic. Its specific gravity is not less than 
1.476 at 77° F. It is a counterirritant and 
narcotic in colic, toothache, and neuralgia. 
Dose internally, from 5 to 15 minims. 

Chrysarobin. Obtained from Goa Pow- 
der in the wood of Vouacapoua araroba. 
Used in skin diseases such as psoriasis, 
chronic eczema ; and also in hemorrhoids. 
Rarely, if ever, used internally. 

Cimicifuga. Black Snakeroot. Black 
Cohosh. The dried rhizome and roots 
of Cimicifuga racemosa. Stomachic, anti- 
spasmodic, expectorant, and diuretic. Heart 
influence same as that of digitalis. Used in 
heart disease, St. Vitus' dance, and ovarian 
neuralgia. Dose of fluidextract, from J / 2 to 
1 fluidrachm ; of the tincture, from 15 
minims to 1 drachm. 

Cinchona. Peruvian Bark. Bark derived 
from the cinchona tree (Cinchona succi- 
rubra) and several species of cinchona 
found on the eastern slopes of the Andes. 
Its active principle is quinine. Astringent, 
bitter tonic, stomachic, stimulates appetite, 
promotes digestion, beneficial in malaria. 
Dose of fluidextract, from 10 minims to 1 
drachm. The Infusion of Cinchona is com- 
posed of Bark, 6 parts ; Aromatic Sulphuric 
Acid, 1 part ; Water, 93 parts. Dose of 
infusion, from 1 drachm to 1 ounce. The 
Compound Tincture of Cinchona is com- 
posed of Bark, 10 parts; Bitter Orange Peel, 
8 parts ; Serpentaria, 1 part ; Alcohol, 80 
parts. Dose, from 1 drachm to y 2 ounce. 

Cinnamon. The inner bark of the shoots 
of the Cinnamomum zeylanicum, found in 
Ceylon, China, and Saigon. It is carmina- 
tive, stimulant, and a flavoring agent. Given 
in flatulence, colic, neuralgia in stomach 
and intestines. The oil is inhaled in con- 
sumption. Dose of the oil, from 1 to 5 
drops on a lump of sugar for flatulent colic 
and pains in the stomach. Dose of the 
powder, 10 to 30 grains. 

Coca. The fluidextract of a South Ameri- 
can tree, the Erythroxylon coca, made from 
the leaves. A tonic. Dose, ^ to 1 drachm. 

Cocaine. An alkaloid derived from Ery- 
throxylon coca. Stimulant, narcotic, and 
local anaesthetic. Cocaine habit results in 
insomnia, loss of mental and moral power, 
emaciation, and death. The hydrochloride 
is the salt most used. Dose, internally, 
from z /i to 1 grain. A cerate of 1 part of 
cocaine to 30 of oil, wax, etc., is used in 
burns. As a local anaesthetic a solution of 
from 2 to 8 per cent is used. It is also 
mixed with oleic acid to form an oleate, 
and with carbolic acid and vaseline as an 
application in a strength of from 5 to 10 



per cent in catarrhs and rheumatism. A 
dangerous drug. 

Cochineal (Coccus). The dried female 
insect Pseudococcus cacti found in Mexico, 
Central America, and southern Europe. 
Used to color tinctures and tooth powders 
and washes. 

Codeine. An alkaloid of opium resem- 
bling morphine, but weaker in its action. 
Used in coughs and diabetes. Dose, from 
y 2 to 2 grains. The two salts of codeine, 
codeine phosphate and codeine sulphate, are 
similar to codeine in medical properties and 
are administered in the same doses. 

Colchicum. Meadow Saffron. The dried 
corm of Colchicum autumnale. Emetic, 
diuretic, diaphoretic, and drastic cathartic. 
Used in rheumatism and acute gout. Dose 
of the root in powder, from 2 to 8 grains ; 
of the seeds in powder, the same. 

Colchicine. An alkaloid obtained from 
colchicum. Its properties are the same as 
those of the corm and seed. Dose, from 
l-150th to l-100th of a grain. 

Collodion (Collodium). Gun Cotton; Py- 
roxylin. Fibers of cotton treated with com- 
bined nitric and sulphuric acid. This solution 
is then dissolved in ether and alcohol. When 
these evaporate, there is left a film which is 
employed as a protective dressing in wounds, 
abrasions, ulcers, and eruptions on the skin. 
It is painted on with a soft brush. Also 
used for holding together the edges of in- 
cised wounds, as a treatment for chilblains, 
and chapped nipples. Blistering collodion 
is made by the addition of cantharides, and 
is a convenient blistering agent. Flexible 
collodion is made by adding Venice turpen- 
tine or other agents to collodion to give 
pliability to the collodion film. Styptic col- 
lodion is formed by the addition of tannic 
acid, which, as an astringent, acts as a 
means of stopping the bleeding of wounds. 

Colocynth. Bitter Apple. The peeled 
dried fruit of Citrullus colocynthus or Bitter 
Cucumber, a native of Turkey, also found 
in parts of Asia and Africa. A powerful 
drastic, hydragogue cathartic used in com- 
bination with other drugs. Dose, from 1 
to 5 grains. 

Confections (Confectiones). Soft solid 
preparations of medicines with which sac- 
charine matter is incorporated. 

Confection of Rose (Confectio Rosae). 
Made of Red Rose, 8 parts ; Sugar, 64 parts ; 
Clarified Honey, 12 parts ; Stronger Rose 
Water, 16 parts. Used chiefly in the mak- 
ing of pills. 

Confection of Senna. Senna, 10 parts; 



794 



MATERIA MEDICA. 



Cassia, 16 parts; Tamarind, 10 parts; Prune, 
sliced, 7 parts; Fig, 12 parts; Sugar, 55.5 
parts ; Oil of Coriander, 5 parts ; Water. 
A very good and pleasant laxative, suited to 
cases of habitual constipation, pregnant 
women, and persons with piles. Dose, 1 to 
2 drachms at bedtime. 

Confection of Sulphur. Sulphur and 
Potassium Bitartrate are the two laxative 
ingredients in this preparation. Dose, 1 to 
2 drachms. 

Conium. Poison Hemlock. Unripe fruit 
of the Conium maculatum, a native of Eu- 
rope but naturalized in the United States. 
Poisonous in large doses. Supposed to be 
the plant used by the Athenians as capital 
punishment in the cases of Socrates, Pho- 
cion, and others. An antispasmodic used 
in acute mania, delirium tremens, lockjaw, 
asthma, and whooping cough. Dose, 3 to 5 
grains. 

Convallaria. Lily of the Valley. The 
dried rhizome and roots of Convallaria 
majalis. A cathartic, diuretic, and heart 
stimulant. Poisonous. Dose, 7^> grains. 

Copaiba. An oleoresin derived from one 
of the many species of Copaiba of South 
America. It is gently stimulant, diuretic, 
and in small doses laxative. It is well 
suited to diseases of the mucous membranes 
such as leucorrhcea, chronic inflammation of 
the bladder, chronic dysentery, diarrhoea, 
hemorrhoids, chronic bronchitis, and psori- 
asis. Dose, from 20 minims to a fluidrachm. 

Copper Sulphate (Cupri Sulphas). Ob- 
tained by the interaction of water, sulphuric 
acid, and metallic copper. Of a rich deep 
blue color. Irritant and slightly escharotic ; 
and, when diluted, stimulant and astringent. 
A powerful and prompt emetic in doses of 
5 grains. Used as an application to indolent 
ulcers, warts, and as a styptic to bleeding 
wounds. As a stimulant wash, it is used 
in the varying strength of 2, 4 or 8 grains 
to a pint of water. Used with lime as an 
insecticide — Bordeaux Mixture — for pre- 
venting blight on potato plants. 

Coriander. The dried ripe fruit (seeds) 
of the Coriandrum sativum, a native of Italy, 
but now spreading throughout Europe. It 
is feebly aromatic, used to conceal the taste 
of nauseous medicines or to correct their 
griping properties. Dose, from 20 to 60 
grains. 

Creosote. A mixture of phenols, guaia- 
col and creosol, obtained in the destructive 
distillation of wood. An excellent antisep- 
tic ; used in nausea, vomiting, diarrhoea, 
hysteria, cholera morbus, cholera infantum, 
typhoid fever, dysentery, menorrhagia, uter- 



ine hemorrhage, fetid ulcers, and largely in 
dentistry. Dose of creosote, from 5 to 10 

minims. 

Decoctions (Decocta). Solutions of the 
medicinal principles of vegetable drugs, de- 
rived by boiling. Decoctions have been 
largely displaced from the pharmacopoeia by 
reason of their large dose, nauseous taste, 
repulsive appearance, and poor keeping qual- 
ities. They have been largely replaced by 
tinctures and fluidextracts. The great dan- 
ger from the indiscriminate use of decoc- 
tions arises from ignorance of the proper 
strength. The physician's advice must be 
sought as to the quantities to be used in all 
cases. 

Compound Decoction of Aloes (Decoc- 
tum Aloes Composition). Made of Extract 
of Barbadoes Aloes, 1 part; Myrrh, Saffron, 
and Potassium Carbonate, ^ part each ; 
Extract of Licorice, 4 parts ; Compound 
Tincture of Cardamoms, 30 parts ; Water, to 
make 100 parts. A tonic, cordial, and ant- 
acid cathartic, and emmenagogue, used in 
dyspepsia, habitual constipation, and amenor- 
rhoea. Dose, y 2 to 2 fluidounces. 

Decoction of Pomegranate Bark (Decoc- 
tum Granati Corticis). Pomegranate Bark, 20 
parts ; Water, 80 parts. An astringent, used 
in diarrhoea, sweats, leucorrhcea, intermittent 
fever, and as a gargle in sore throat. Dose, 
H to 2 fluidounces. 

Decoction of Logwood (Decoctum hae- 
matoxyli). Logwood in Chips, 5 parts; Cin- 
namon Bark, 0.8 parts; Water, to make 100 
parts. An excellent astringent in diarrhoeas 
of relaxation. Dose for an adult, 2 fluid- 
ounces ; for a child of two years, 2 or 3 
fluidrachms. 

Digitalis. Foxglove. The leaves of Digi- 
talis purpurea. Used as a powerful heart 
stimulant and a diuretic. Dose of digitalis 
leaves, 1 to 2 grains. 

Elaterinum. The principle obtained from 
the juice of the fruit of Ecballium ela- 
terium, or squirting cucumber, found in 
southern Europe. A powerful hydragogue 
cathartic and diuretic. Used largely in 
dropsy. Dose, 1-20 to 1-10 of a grain. 

Elixirs (Elixiria). Aromatic, sweetened, 
spirituous mixtures, containing active medic- 
inal substances in small quantities. 

Aromatic Elixir (Elixir Aromaticum). 
Sometimes called Simple Elixir. Compound 
Spirit of Orange, 1.2 parts; Syrup, 37.5 
parts ; Purified Talc, 3 parts ; Alcohol, to 
make 100 parts. Used as a base or vehicle 
for administering medicines. Sometimes 
colored with cochineal or caramel. 



MATERIA MEDICA. 



795 



Adjuvant Elixir (Elixir Adjuvans). 
Fluidextract of Glycyrrhiza, 12 parts ; Aro- 
matic Elixir, 88 parts. Used as a vehicle or 
base for administering and disguising the 
taste of medicines. 

Elixir of Iron, Quinine, and Strych- 
nine Phosphates (Elixir Ferri, Quininae, 
et Strychninae Phosphatnm). Soluble Ferric 
Phosphate, 1.75 parts; Quinine, 0.875 parts; 
Strychnine, 0.0275 parts; Phosphoric Acid, 
0.2 parts ; Ammonium Carbonate, 0.9 parts ; 
Alcohol, 6 parts; Acetic Acid, 2.865 parts; 
Ammonia Water, Water, and Aromatic 
Elixir, of each enough to make up 100 parts. 
Dose, 1 to 2 fluidrachms. 

Emplastra or Plasters. Solid com- 
pounds intended if or external application ; 
will adhere to the body ; and of such a con- 
sistency that the preparation must be heated 
in order to spread it upon leather, linen, 
or muslin. 

Emplastrum Adhesivum or Adhesive 
Plaster. Made from Lead Plaster to 
which a little Rubber and Petrolatum are 
added. Much used for holding the edges 
of wounds in place and for dressing ulcers. 

Emplastrum Ammoniaci cum Hydrar- 

GYRO OR AMMONIACUM AND MERCURY PlAS- 

ter. Made from Ammoniac, Mercury, Oleate 
of Mercury, Diluted Acetic Acid, and Lead 
Plaster. Used in enlargement of the glands, 
swelling of the joints; and over the liver 
in chronic hepatitis. 

Emplastrum Belladonnae or Bella- 
donna Plaster. Made from 70 parts Ad- 
hesive Plaster to which 30 parts Extract of 
Belladonna Leaves are added. A useful ano- 
dyne application in neuralgia and rheuma- 
tism. 

Emplastrum Capsici or Capsicum Plas- 
ter. Made from the Oleoresin of Capsicum 
and Adhesive Plaster. A rubefacient. 

Emplastrum Hydrargyri or Mercury 
Plaster. Composed of Mercury, Oleate of 
Mercury, Hydrous Wool-fat, and Lead Plas- 
ter. Contains 30 per cent of mercury. A 
means of introducing mercury into the sys- 
tem. 

Emplastrum Opii or Opium Plaster. 
Made of the Extract of Opium and Adhe- 
sive Plaster. For the relief of rheumatic 
and other pains. 

Emplastrum Plumbi or Lead Plaster. 
Sometimes called Diachylon Plaster. Com- 
posed of Soap, Lead Acetate, and Water. 
Used as an application to excoriated sur- 
faces, slight wounds, and as a protective. 
Enters largely into the preparation of other 
plasters. 



Emplastrum Saponis or Soap Plaster. 
Composed of Soap, Lead Plaster, and Water. 
A discutient often applied to tumors. 

Emulsions (Emulsa). Liquids which 
hold oleaginous bodies in suspension in 
watery fluids, by means of gum or other 
viscid substances. They are used to render 
administration of medicines easy, to conceal 
the bad taste, or to prevent nauseating 
effects of disagreeable medicines. Their 
excellence depends entirely upon the inti- 
macy of the mixture. 

Emulsion of Almond (Emulsum Amyg- 
dalae) or Milk of Almond. Sweet Almond, 
6 parts ; Acacia, 1 part ; Sugar, 3 parts ; 
Water, to make 100 parts. Used as a de- 
mulcent in catarrhal, dysenteric, and inflam- 
matory conditions. Dose, 2 to 8 fluidounces. 

Emulsion of Asafoetida (Emulsum Asa- 
foetidae) or Milk of Asafoetida. Asafoetida, 
4 parts ; Water, 96 parts. Dose, J / 2 to 1 
fluidounce. 

Emulsion of Chloroform (Emulsum 
Chloroformi). Chloroform, 4 parts; Ex- 
pressed Oil of Almond, 6 parts ; Tragacanth, 

1 part ; Water, 89 parts. An agreeable 
method of administering chloroform. Dose, 

2 to 8 fluidrachms. 

Emulsion of Cod-Liver Oil (Emulsum 
Olei Morrhuae). Cod-Liver Oil, 50 parts; 
Acacia, 12.5 parts; Syrup, 10 parts; Oil of 
Gaultheria, 0.4 parts; Water, to make 100 
parts. Sometimes Oil of Bitter Almond is 
used in place of Oil of Gaultheria. Dose, 
2 to 4 fluidrachms. 

Emulsion of Cod-Liver Oil with Hypo- 
phosphites (Emulsum Olei Morrhuae cum 
Hypophosphitibus) . Cod-Liver Oil, 4 parts; 
Acacia, 12.5 parts; Calcium Hyphosphite, 1 
part; Potassium Hypophosphite, 0.5 part; 
Sodium Hypophosphite, 0.5 part; Syrup, 10 
parts ; Oil of Gaultheria, 0.4 part ; Water, to 
make 100 parts. Dose, 2 to 4 fluidrachms. 

Emulsion of Oil of Turpentine (Emul- 
sum Olei Terebinthinae). Rectified Oil of 
Turpentine, 1.5 parts; Expressed Oil of 
Almond, 0.5 part ; Syrup, 2.5 parts ; Acacia, 
1.5 parts; Water, to make 100 parts. Dose, 
1 to 2 fluidrachms. 

Ergot (Ergota). A fungus (Claviceps 
purpurea) which grows on rye. It is a 
stimulant and causes contraction of the in- 
voluntary muscles. Controls hemorrhage 
and causes contraction of the womb. Em- 
ployed also in night sweats, diabetes, and 
congestion of the spine. Dose, from 10 
grains to 1 drachm. 

Ether (Aether). An anaesthetic made 
officially by the action of sulphuric acid on 



796 



MATERIA MEDICA. 



alcohol (1870) ; but this is superseded by 
Squibb's process. Specific gravity, 0.716 to 
0.717 at 25° C. or 77° F. Boils at 35.5° C. 
or 96° F. First used as an anaesthetic in 
1846 by Dr. Warren at the Massachusetts 
General Hospital, on the suggestion of W. 
T. G. Morton of Boston. Locally a violent 
irritant. A stimulant antispasmodic in 
Hoffman's Anodyne. Heart stimulant in 
heart failure, and a carminative. Internal 
dose, from 30 minims to 1 fluidrachm in 
cold water. 

Ethyl Chloride (Aethylis Chloridum). 
Prepared by the action of hydrochloric acid 
on absolute ethyl alcohol. Used to produce 
local anaesthesia by freezing in dental and 
surgical cases. Supplied in glass tubes her- 
metically sealed. From these, when the 
glass tube is broken, the ethyl chloride 
streams out upon the part by the force of 
its ovi great volatility. Acts as a general 
anaesthetic, similar to chloroform. 

Eucalyptol. A liquid with pungent taste 
and an odor like that of camphor, derived 
from an Australian tree (Eucalyptus globu- 
lus). It is a deodorant, disinfectant, and 
astringent ; applied to wounds, and used 
also to check discharges ; used internally 
in malarial fever, asthma, and bronchitis ; 
also inhaled in diphtheria and tuberculosis. 
Dose, 5 to 10 minims in capsule. 

Eucalyptus. The dried leaves of Euca- 
lyptus globulus, native of Australia, but 
grown artificially in America. A stimulant 
expectorant used in the advanced stages of 
acute and chronic bronchitis, asthma, and 
genito-urinary inflammations. A local, stim- 
ulant, and antiseptic application in skin dis- 
eases. Dose, 10 to 30 grains; of the oil, 
5 to 10 minims. 

Eugenol (Synthetic Oil of Cloves). A 
phenol obtained from oil of cloves and 
other sources. Medicinal uses are the same 
as those of the oil of cloves. Dose, 2 to 5 
minims. 

Euonymus (Wahoo). The dried bark 
of the Euonymus atropurpureus, growing 
in the northern and western states. A laxa- 
tive and choiagogue, used in dropsy. Dose, 
5 to 15 grains. 

Eupatorium or Boneset. Also called 
Thoroughwort. The dried leaves and flow- 
ering tops of Eupatorium perfoliatum, com- 
mon in the United States. Tonic, diaphoretic, 
and in large doses emetic and aperient. 
Given at the commencement of influenza, 
muscular rheumatism, or a general cold. 
Tonic in dyspepsia and general debility. 
Dose, 20 to 30 grains. 

Extracts (Extracta). Solid preparations 
made by evaporating solutions of vegetable 



principles obtained by solution or by ex- 
pressing the juice from green plants. They 
are generally used to administer medicines 
in pill form. 

Extract of Aloes (Extractum Aloes). 
Gives aloes in a purified form. For medici- 
nal properties, see Aloes. Dose, 2 to 10 
grains. 

Extract of Belladonna Leaves (Ex- 
tractum Belladonnae Foliorum). Contains 
1.4 per cent of the alkaloids. Dose, 1-6 to 
1-3 of a grain. 

Extract of Indian Cannabis (Extractum 
Cannabis Indicae). Formerly called Indian 
Hemp. Dose, % of a grain. 

Extract of Cimicifuga (Extractum 
Cimicifugae). Dose, 3 to 10. grains. 

Extract of Colchicum Corm (Extractum 
Colchici Cormi). Dose, % to 1 grain. 

Extract of Colocynth (Extractum Colo- 
cynthidis). Dose, y 2 grain. 

Compound Extract of Colocynth (Ex- 
tractum Colocynthidis Compositum). Ex- 
tract of Colocynth, 16 parts; Aloes, 50 
parts ; Cardamom, 6 parts ; Resin of Scam- 
mony, 14 parts; Soap, 14 parts; Alcohol, 10 
parts. An energetic and safe cathartic ; 
enters into composition of the Compound 
Cathartic Pill. Dose, as a laxative, 1 to 2 
grains; as a purgative, 5 to 10 grains. 

Extract of Digitalis (Extractum Digi- 
talis). Dose, ^4 grain. 

Extract of Ergot (Extractum Ergotae). 
The best preparation of ergot. Dose, 5 to 
15 grains. 

Extract of Euonymus (Extractum Eu- 
onymi). The name "euonymin" is often 
wrongly given to the dried and powdered 
extract. Dose, 1 to 3 grains. 

Extract of Gentian (Extractum Gen- 
tianae). Dose, 5 to 10 grains. 

Extract of Licorice, Extract of Glyc- 
yrrhiza (Extractum Glycyrrhizae). Made 
from the root of Glycyrrhiza glabra. A 
useful demulcent, used in cough mixtures ; 
conceals taste of medicines, and gives mass 
to troches and pills. 

Extract of Logwood, Extract of Hae- 
matoxylon (Extractum Haematoxyli). Made 
from a decoction. Dose, 10 to 30 grains. 

Extract of Hyoscyamus (Extractum 
Hyoscyami). Dose, from 1 to 2 grains. 

Extract of Krameria (Extractum Kra- 
meriae). Called also Extract of Rhatany. 
Dose, 5 to 20 grains. 

Extract of Leptandra {Extractum Lep- 



MATERIA MEDICA. 



797 



tandrae). Called also Extract of Culver's 
Root. Dose, 5 to 10 grains. 

Extract of Malt {Extractum Malti). A 
good emulsifying agent. Dose, 1 to 4 
fluidrachms. 

Extract of Nux Vomica {Extractum 
Nucis Vomicae). Contains 5 per cent of 
strychnine. Dose, % to y 2 a grain. 

Extract of Opium {Extractum Opii). 
Contains 20 per cent of morphine. Dose, 
Ya, to 1 grain. 

Extract of Physostigma {Extractum 
Physostigmatis). Called also Extract of 
Calabar Bean. Dose, 1-12 to % of a grain. 

Extract of Quassia {Extractum Quas- 
siae). Dose, 1 to 2 grains. 

Extract of Cascara Sagrada {Extractum 
Rhamni Purshianae). Dose, 2 to 8 grains. 

Extract of Rhubarb {Extractum Rhei). 
Dose, 2 to 10 grains. 

Extract of Scopola {Extractum Scopo- 
lae). Largely used in the manufacture of 
Belladonna Plasters. Contains 2 per cent 
of the alkaloids. Dose, % to %. grain. 

Extract of Stramonium {Extractum 
Stramonii). Contains 1 per cent of the 
alkaloids. Dose, 1-6 to ]/$ grain. 

Extract of Sumbul {Extractum Sumbul). 
Called also Extract of Muskroot. Dose, 2 
to 5 grains. 

Extract of Taraxacum {Extractum 
Taraxaci). Called also Extract of Dande- 
lion. Dose, 15 grains to 1 drachm. 

Fel Bovis or Oxgall. The fresh bile of 
Bos taurus. 

Fel Bovis Purifactum or Purified Ox- 
gall. This formerly occupied a place in 
medicine but is rapidly passing into disuse. 
Employed in catarrhal jaundice. Dose, 5 to 
20 grains. 

Fennel. The dried ripe fruit of Foenic- 
ulum vulgare cultivated in the gardens of 
Europe. A grateful aromatic, used as a 
carminative and as a corrective of senna, 
rhubarb, and other unpleasant medicines. 
Dose of the powdered seeds, 20 grains to 
y^ a drachm. 

Ferri Carbonas Saccharatus or Sac- 
charated Ferrous Carbonate. An excel- 
lent chalybeate readily soluble in acids. 
Dose, 5 to 30 minims. 

Ferri Chloridum or Ferric Chloride. 
Sometimes called Iron Perchloride. Used 
principally to prepare the tincture. 

Ferri Citras or Ferric Citrate. A 
pleasant chalybeate. Dose, 3 to 10 grains. 



Ferri et Ammonii Citras or Iron and 
Ammonium Citrate. A pleasant chalybeate. 
Dose, 3 to 8 grains. 

Ferri et Ammonii Sulphas or Ferric 
Ammonium Sulphate. Useful in leucor- 
rhcea, and as a styptic on account of its 
astringency. 

Ferri et Ammonii Tartras or Iron and 
Ammonium Tartrate. A mild chalybeate. 
Dose, 5 to 10 grains. 

Ferri et Potassii Tartras or Iron and 
Potassium Tartrate. A mild, agreeable 
chalybeate, of slight astringency, and easily 
borne by the stomach. One of the best iron 
preparations for children. Dose, adult, 5 
to 10 grains. 

Ferri et Quininae Citras or Iron and 
Quinine Citrate. A tonic combining the 
properties of both iron and quinine. Dose, 
5 to 6 grains three times a day. The Sol- 
uble Citrate of Iron and Quinine is em- 
ployed for the same purpose as the Iron and 
Quinine Citrate. It is used in the prepara- 
tion of the Bitter Wine of Iron. 

Ferri et Strychninae Citras or Iron 
and Strychnine Citrate. An efficient 
tonic, but the doses of the respective agents 
cannot be varied as might in some cases be 
desirable. Dose, 3 to 5 grains in pill. 

Ferri Hydroxidum or Ferric Hydrox- 
ide. The great antidote for arsenic poison- 
ing by rendering arsenic trioxide insoluble, 
and therefore incapable of being absorbed 
into the system. For this purpose it is 
usually mixed with Magnesium Oxide and 
administered in a dose of 4 fluidounces. 

Ferri Hypophosphis or Ferric Hypo- 
phosphite. Especially employed in phthisis 
and anaemic conditions. Dose, 5 to 10 
grains. 

Ferri Pyrophosphas Solubilis or Sol- 
uble Ferric Pyrophosphate. A mild and 
good chalybeate which is much used because 
of its ready solubility ; it can be adminis- 
tered as pill, simple solution in water, or 
as a syrup. Dose, 2 to 10 grains. 

Ferri Sulphas or Ferrous Sulphate. 
Called also Copperas. Very astringent ; used 
in hemorrhages, sweats, leucorrhcea and 
other excessive discharges. A feeble disin- 
fectant. Dose, 2 to 5 grains. Dried Fer- 
rous Sulphate is used for making pills, a 
form in which the crystallized sulphate is 
not suited. Granulated Ferrous Sulphate is 
little liable to oxidation, and is the best 
form for dispensing the sulphate. 

Ferrum Reductum or Reduced Iron. 
Contains not less than 90 per cent of pure 
iron. It is one of the best chalybeate tonics, 



79 8 



MATERIA MEDICA. 



remarkably free from astringency and yields 
the largest proportion of iron to the gastric 
juice. Dose, 1 to 3 grains several times a 
day. 

Fluidextracts {Fluid extract a). The most 
important class of liquid preparations now 
in use. In 1850 there was only one recog- 
nized — the fluidextract of sarsaparilla. Now 
there are 85 official fluidextracts and a great 
number of unofficial preparations almost 
daily increasing. Their advantage consists 
in concentrating a great quantity of a 
medicinal agent into small liquid space and 
of known strength ; for each cubic centi- 
meter of fluidextract contains 1 gramme of 
the crude drug. They are also in convenient 
form to administer, and, as the evaporation 
process by which they are made is not car- 
ried to the same degree as is required to 
make solid extracts, there is less danger 
of injuring the medicinal principles by em- 
ploying too great heat. By regulation of 
the 8th Revision of the U. S. P. (1900) :— 
100 grammes of drug make 100 c.c. of 
Fluidextract. 

100 troy ounces of drug make 105.4 fluid- 
ounces of Fluidextract. 

100 avoirdupois ounces of drug make 96 
fluidounces of Fluidextract. 
Fluidextract of Aconite, Fluidextr actum 

Aconiti. Dose, ^ to 1 minim. 
Fluidextract of Apocynum or of Indian 
Hemp, Fluidextractum Apocyni. Dose, 5 
to 10 minims; as an emetic, 15 to 20 
minims. 
Aromatic Fluidextract, Fluidextractum Aro- 

maticum. Dose, 10 to 20 minims. 
Fluidextract of Belladonna Root, Fluidex- 
tractum Belladonnae Radicis. Dose, 1 to 
2 minims. 
Fluidextract of Berberis, Fluidextractum 

Berberis. Dose, ^ to 1 fluidrachm. 
Fluidextract of Bitter Orange Peel, Fluid- 
extractum Aurantii Amaru Dose, 15 to 
30 minims. 
Fluidextract of Buchu, Fluidextractum 
Buchu. Dose, 30 minims to 1 fluidrachm. 

Fluidextract of Calamus, Fluidextractum 
Calami. Dose, 5 to 15 minims. 

Fluidextract of Calumba, Fluidextractum 
Calumbae. Dose, 15 to 30 minims. 

Fluidextract of Indian Cannabis, Fluidex- 
tract Cannabis Indicae. Dose, 1 to 2 
minims. 

Fluidextract of Capsicum, Fluidextractum 
Capsici. Dose, ^ to 1 minim. 

Fluidextract of Cascara Sagrada, Fluidex- 
tractum Rhamni Purshianae. Dose, 15 
minims to 1 fluidrachm. 



Fluidextract of Chimaphila, Fluidextractum 

Chimaphilae. Dose, 1 fluidrachm. 
Fluidextract of Chirata, Fluidextractum 

Chiratae. Dose, x / 2 fluidrachm. 
Fluidextract of Cimicifuga, Fluidextractum 

Cimicifugae. Dose, 15 minims to 1 

fluidrachm. 

Fluidextract of Cinchona, Fluidextractum 

Cinchonae. Dose, 5 to 20 minims. 
Fluidextract of Coca, Fluidextractum Cocae. 

Dose, 20 minims to 1 fluidrachm. 
Fluidextract of Colchicum Seed, Fluidex- 
tractum Colchici Seminis. Dose, 2 to 8 

grains. 
Fluidextract of Conium, Fluidextractum 

Conii. Dose, 3 to 5 minims. 
Fluidextract of Convallaria, Fluidextractum 

Convallariae. Dose, 5 to 15 minims. 
Fluidextract of Cubebs, Fluidextractum 

Cubebae. Dose, 10 to 40 minims. 
Fluidextract of Cypripedium, Fluidextractum 

Cypripedii. Dose, 15 minims. 
Fluidextract of Digitalis, Fluidextractum 

Digitalis. Dose, 1 to 2 minims. 
Fluidextract of Ergot, Fluidextractum Er- 

gotae. Dose, y 2 a fluidrachm to ^ a 

fluidounce. 
Fluidextract of Eriodictyon, Fluidextractum 

Eriodictyi. Dose, 15 minims to 1 

fluidrachm. 
Fluidextract of Eucalyptus, Fluidextractum 

Eucalypti. Dose, 10 to 30 minims. 
Fluidextract of Euonymus, Fluidextractum 

Euonymi. Dose, as a laxative, 5 to 15 

minims ; as a purgative, 1 fluidrachm. 
Fluidextract of Eupatorium, Fluidextractum 

Eupatorii. Dose, 20 minims to 1 flui- 
drachm. 
Fluidextract of Frangula, Fluidextractum 

Frangulae. Dose, 10 to 20 minims. 
Fluidextract of Gelsemium, Fluidextractum 

Gelsemii. Dose, 2 to 3 minims. 
Fluidextract of Gentian, Fluidextractum 

Gentianae. Dose, 10 to 30 minims. 
Fluidextract of Geranium, Fluidextractum 

Geranii. Dose, 30 minims to.l fluidrachm. 
Fluidextract of Ginger, Fluidextractum 

Zingiberis. Dose, 10 to 20 minims. 
Fluidextract of Glycyrrhiza, Fluidextractum 

Glycyrrhizae. Not given alone. 
Fluidextract of Grindelia, Fluidextractum 

Grindeliae. Dose, ^ to 1 fluidrachm. 
Fluidextract of Guarana, Fluidextractum 

Guaranae. Dose, 1 to 2 fluidrachms. 
Fluidextract of Hamamelis Leaves, Fluid- 
extractum Hamamelidis Foliorum. Dose, 

V 2 fluidrachm. 



MATERIA MEDICA. 



799 



Fluidextract of Hydrastis, Fluidextr actum 
Hydrastis. Dose, 15 minims to 1 flui- 
drachm. 

Fluidextract of Hyoscyamus, Fluidextr actum 
Hyoscyami. Dose, 5 to 10 minims. 

Fluidextract of Ipecac, Fluidextr actum Ipe- 
cacuanhae. Dose, as an expectorant, 1 
to 2 minims; as an emetic, 15 to 30 
minims. 

Fluidextract of Krameria, Fluidextractum 
Krameriae. Dose, 10 minims to 1 flui- 
drachm. 

Fluidextract of Lappa, Fluidextractum Lap- 
pae. Dose, 30 to 60 minims. 

Fluidextract of Leptandra,, Fluidextractum 
Leptandrae. Dose, 20 minims to 1 flui- 
drachm. 

Fluidextract of Lobelia, Fluidextractum 
Lobeliae. Dose, as an expectorant, 1 to 
5 minims; as an emetic, 10 to 20 minims. 

Fluidextract of Lupulin, Fluidextractum 
Lupulini. Dose, 5 to 15 minims. 

Fluidextract of Matico, Fluidextractum 
Matico. Dose, ^ to 1 fluidrachm. 

Fluidextract of Mezereum, Fluidextractum 
Mezerei. Not used internally. 

Fluidextract of Nux Vomica, Fluidextractum 
Nucis Vomicae. Dose, 1 to 3 minims. 

Fluidextract of Pareira, Fluidextractum 
Pareirae. Dose, ^ to 1 fluidrachm. 

Fluidextract of Phytolacca, Fluidextractum 
Phytolaccae. Dose, as an alterative, 1 to 
5 minims; as an emetic, 15 to 30 minims. 

Fluidextract of Pilocarpus, Fluidextractum 
Pilocarpi. Dose, 15 minims to y 2 flui- 
drachm. i 

Fluidextract of Podophyllum, Fluidex- 
tractum Podophylli. Dose, 5 to 15 minims. 

Fluidextract of Pomegranate, Fluidex- 
tractum Granati. Dose, y 2 to 1 fluidrachm. 

Fluidextract of Quassia, Fluidextractum 
Quassiae. Dose, 5 to 10 minims. 

Fluidextract of Quillaja, Fluidextractum 
Quillajae. Dose, 3 to 10 minims. 

Fluidextract of Rhubarb, Fluidextractum 
Rhei. Dose, as a laxative, 5 to 10 min- 
ims; as a purgative,, 20 to 30 minims. 

Fluidextract of Rhus Glabra, Fluidex- 
tractum Rhois Glabrae. Dose, 10 to 20 
minims. 

Fluidextract of Rose, Fluidextractum Rosae. 
Dose, 1 to 2 fluidrachms. 

Fluidextract of Rubus, Fluidextractum Rubi. 
Dose, ^ to 1 fluidrachm. 

Fluidextract of Sanguinaria, Fluidextractum 
Sanguinariae. Dose, 1 to 5 minims. 

Fluidextract of Sarsaparilla, Fluidextractum 
Sarsaparillae. Dose, 30 to 60 minims. 



Compound Fluidextract of Sarsaparilla, 

Fluidextractum Sarsaparillae Compositum. 

Dose, 30 minims to 1 fluidrachm. 
Fluidextract of Savine. Fluidextractum Sa- 

binae. Dose, 3 to 8 minims. 
Fluidextract of Squill, Fluidextractum Scil- 

lae. Dose, 2 to 3 minims. 
Fluidextract of Scopola, Fluidextractum 

Scopolae. Dose, 1 to 3 minims. 
Fluidextract of Scutellaria, Fluidextractum 

Scutellariae. Dose, y 2 to 1 fluidrachm. 
Fluidextract of Senega, Fluidextractum 

Senegae. Dose, 5 to 20 minims. 
Fluidextract of, Senna, Fluidextractum Sen- 

nae. Dose, y 2 to 2 fluidrachms. 
Fluidextract of Serpentaria, Fluidextractum 

Serpentariae. Dose, 20 to 30 minims. 
Fluidextract of Spigelia, Fluidextractum 

Spigeliae. Dose, 1 to 2 fluidrachms. 
Fluidextract of Staphisagria, Fluidextractum 

Staphisagriae. An external application. 
Fluidextract of Stillingia, Fluidextractum 

Stillingiae. Dose, 15 to 45 minims. 
Fluidextract of Stramonium, Fluidextractum 

Stramonii. Dose, 1 to 2 minims. 
Fluidextract of Sumbul, Fluidextractum 

Sumbul. Dose, ^ to 1 fluidrachm. 
Fluidextract of Taraxacum, Fluidextractum 

Taraxaci. Dose, 1 to 3 fluidrachms. 

Fluidextract of Triticum, Fluidextractum 
Tritici. Dose, 3 to 6 fluidrachms. 

Fluidextract of Uva Ursi, Fluidextractum 
Uvae Ursi. Dose, 3-0 minims to 1 flui- 
drachm. 

Fluidextract of Valerian, Fluidextractum 
Valerianae. Dose, 30 minims to 1 flui- 
drachm. 

Fluidextract of Veratrum, Fluidextractum 
Veratri. Dose, 1 to 2 minims. 

Fluidextract of Viburnum Opulus, Fluidex- 
tractum Viburni Opuli. Dose, T / 2 to 1 
fluidrachm. 

Fluidextract of Viburnum Prunifolium, 
Fluidextractum Viburni Prunifolii. Dose, 
y 2 to 1 fluidrachm. 

Fluidextract of Wild Cherry, Fluidextractum 
Pruni Virginianae. Dose, 30 minims to 
1 fluidrachm. 

Fluidextract of White Oak Bark, Fluidex- 
iractum Querci. Dose, 15 minims to 1 
fluidrachm. 

Fluidextract of Xanthoxylum, Fluidex- 
tractum Xanthoxyli. Dose, y 2 to 1 flui- 
drachm. 
Frangula or Buckthorn. The dried 

bark of Rhamnus frangula, found in Europe 

and Russian Asia. An active cathartic like 



8oo 



MATERIA MEDICA. 



rhubarb. Dose, 15 to 30 grains of bark, or 
a tablespoonful of a decoction made of one 
ounce to the pint. 

Gambir or Pale Gatechu. Made from 
the leaves and twigs of Ourouparia gambir, 
a native of Malacca, Sumatra, Cochin China. 
A useful astringent in diarrhoea, hemor- 
rhage, relaxation of the uvula, irritation of 
the fauces, troublesome cough, and spongy 
gums. Dose, from 10 grains to ^a drachm. 

Gelatine (Gelatinum). Derived from 
skin, ligaments, bones, and other animal 
tissues treated with boiling water. Used for 
making capsules. Taken internally it coag- 
ulates the blood and is useful in aneurism, 
hemorrhage, menorrhagia, hemoptysis, hema- 
temesis, and is styptic. Dose, J^ to 1 ounce. 
Glycerinated Gelatine is made from equal 
parts of gelatine and glycerine with water to 
make a jelly used in making suppositories. 

Gelsemium or Yellow Jasmine. The 
rhizome and roots of Gelsemium semper- 
virens, found in the Southern States. Used 
in supraorbital neuralgia, dysmenorrhcea, 
toothache, intermittent and remittent fevers, 
cardiac palpitations. Dose, 1 or 2 grains ; 
but best administered as fluidextract or 
tincture. 

Gentian (Gentiana). The rhizome and 
roots of Gentiana lutea, found in mountain- 
ous regions of Europe. One of the best 
tonics of the simple bitters ; excites appe- 
tite and improves digestion. Used in dys- 
pepsia, gout, amenorrhoea, hysteria, scrofula, 
and intermittent fevers. Dose, 15 to 30 
grains. 

Geranium or Cranesbill. The dried 
rhizome of Geranium maculatum, common 
throughout the United States. One of our 
best astringents ; used in diarrhoea, chronic 
dysentery, later stages of cholera infantum, 
and hemorrhages. Used also as an external 
application to indolent ulcers; an injection 
in leucorrhcea ; and a gargle in relaxation 
of the uvula, and ulcerations of the mouth. 
Given in powder, decoction, tincture, and 
fluidextract. Dose of the substance, from 
15 to 30 grains. 

Glycerine or Glycerol. A liquid obtained 
from the decomposition of animal and vege- 
table fats or fixed oils. It is a triatomic alco- 
hol. A vehicle for other medicines ; a 
laxative ; externally as a softening emollient 
application to the skin. 

Glycerine of Alum {Glycerinum Alumi- 
nis). Powdered Alum, about 6 parts; 
Water, about 6 parts ; Glycerine, about 88 
parts. A good astringent application. 

Glycerine of Borax (Glycerinum Boracis). 
Borax, about 6 parts ; Glycerine, about 94 



parts. A useful means of applying borax 
to mouths of children suffering from thrush 
and other forms of sore mouth. The part 
is painted with the mixture and covered 
with raw cotton when practicable. 

Glycerites (Glycerita). Solutions of 
medicinal substances in glycerine. 

Glycerite of Tannic Acid (Glyceritum 
Acidi Tannici). Tannic Acid, 20 parts; 
Glycerine, 80 parts. The most useful prepa- 
ration of tannic acid for external use ; espe- 
cially good as an application to sore nipples 
of nursing mothers. Dose internally, 10 to 
40 minims. 

Glycerite of Starch (Glyceritum Amy li). 
Starch, 10 parts; Water, 10 parts; Glycer- 
ine, 80 parts. 

Glycerite of Boroglycerine (Glyceritum 
Boroglycerini). Sometimes called Solution 
of Boroglyceride. Boric Acid, 31 parts; 
Glycerine, 69 parts. A very soluble form 
of antiseptic boric acid. 

Glycerite of the Phosphates of Iron, 
Quinine, and Strychnine (Glyceritum 
Ferri, Quininae, et Strychninae Phosphatum). 
Soluble Ferric Phosphate, 8 parts ; Quinine, 
10.4 parts; Strychnine, .08 part; Phosphoric 
Acid, 20 parts ; Glycerine, 50 parts. Used 
as a convenient method of making the syrup 
of the phosphates of iron, quinine, and 
strychnine, by mixing 1 volume of the gly- 
cerite with 3 volumes of syrup. 

Glycerite of Hydrastis (Glyceritum 
Hydrastis). Dose, y 2 to 1 fluidrachm. 

Glycerite of Phenol (Glyceritum Phe- 
nolis). Sometimes called Glycerite of Car- 
bolic Acid. A 20 per cent by volume phenol 
solution in glycerine. Used internally and 
externally in a diluted state. Its properties 
are those of phenol or carbolic acid. Dose, 
5 to 10 minims. 

Glycyrrhiza or Licorice Root. The 
rhizome and root of Glycyrrhiza glabra, 
found in Asia Minor, Persia, and India. 
Cultivated in Europe. An excellent demul- 
cent in pulmonic catarrhs ; chiefly used for 
concealing the taste of disagreeable medi- 
cines. The powder is used as a coating for 
pills. 

Grindelia. Dried leaves and flowering 
tops of Grindelia robusta, found in the 
western parts of both Americas. An anti- 
spasmodic in asthma, bronchitis, and whoop- 
ing cough. Also used in chronic catarrh 
of the bladder. Dose, 30 to 40 grains. 

Guaiacol. One of the principal constitu- 
ents of creosote. A local irritant with some 
anaesthetic powers. Less germicidal than 



MATERIA MEDICA. 



801 



phenol or creosote. Used internally in 
phthisis and bronchitis ; externally in lupus. 
Dose, 5 to 10 minims. 

Guaiacol Carbonate (Guaiacolis Car- 
bonas). Differs from guaiacol by its taste- 
lessness and absence of irritant properties. 
Dose, 15 to 20 grains. 

Guaiacum. The resin of the wood of 
Guaiacum officinale, found in many of the 
West Indies. Stimulant, alterative, laxa- 
tive, and diaphoretic. Used in rheumatism, 
gout, scrofula, and skin diseases. Dose, 10 
to 30 grains. 

Guarana. Dried paste of the crushed 
seeds of Paullinia cupana, found in South 
America. Used in migraine,, and chronic 
diarrhoea. Dose, 20 to 60 grains. 

Haematoxylon or Logwood. The heart 
wood of Haematoxylon campechianum, 
found in tropical America. A mild astrin- 
gent without irritating effects. Useful in 
cholera infantum, chronic diarrhoea, and 
dysentery. Dose, 10 to 20 grains. 

Hamamelidis Cortex or Hamamelis 
Bark. The bark and twigs of Hamamelis 
Virginiana or Witch Hazel. Dose of leaves 
or bark, 30 grains. 

Hedeoma or Pennyroyal. The dried 
leaves and flowering tops of Hedeoma pu- 
le gioides. A gently stimulating aromatic ; 
used in flatulence, colic, and sick stomach. 
A copious draught of the warm tea at bed- 
time with a hot foot bath is a popular rem- 
edy for suppressed menses. Dose, 2 
drachms. 

Homatropine Hydrobromide (Homatro- 
pinae Hydrobromidum). An alkaloid salt 
possessing many of the properties cf atro- 
pine. Used in a solution of four grains to 
the ounce for dilating the pupil. Dose, 
l-150th to l-60th of a grain. 

Hops (Humulus). The dried strobiles of 
Hamulus lupulus, cultivated widely. Tonic, 
used in dyspepsia, nervous tremors, wake- 
fulness ; and fomentations of hops are often 
helpful in pain. Dose, 30 to 90 grains. 

Hydrargyri Chloridum Corrosivum, Bi- 
chloride of Mercury or Corrosive Subli- 
mate. A specific in syphilis. Used exter- 
nally it is stimulant, germicidal, and eschar- 
otic. A wash for indolent ulcers and for 
ringworm. One part of corrosive sublimate 
in 20,000 of water will kill germs ; gener- 
ally prepared in the form of tablets of cal- 
culated strength, so that solutions of any 
desired strength are easily prepared. One 
tablet in a half pint of water will make a 
1 in 1,000 solution. Dose, l-100th to ■% 
grain after meals in pill. 



Hydrargyri Chloridum Mite, Mild 
Mercurous Chloride or Calomel. In ad- 
dition to the general specific properties of 
mercurials, calomel is purgative and anthel- 
mintic, and is the most valuable of the mer- 
curial preparations. Employed in bilious 
fevers, hepatitis, jaundice, bilious colic, 
painters' colic, dysentery, and worms. When 
given alone it should be followed by a dose 
of castor oil. Dose as an alterative, y 2 to 
1 grain; as a purgative, 5 to 15 grains. To 
a child two or three years old, from 2 to 3 
grains as a purge. 

Hydrargyri Iodidum Flavum or Yellow 
Iodide of Mercury. Used in advanced 
syphilis. Dose, 1-5 of a grain. 

Hydrargyri Iodidum Rubrum or Red 
Iodide of Mercury. Used in scrofula, 
syphilis, and applied externally to lupus. 
Dose, 1-20 of a grain. 

Hydrargyri Oxidum Flavum or Yellow 
Mercuric Oxide. Used in local treatment 
of the eye, usually administered in the form 
of an ointment or as the Oleate of Mercury. 

Hydrargyri Oxidum Rubrum or Red 
Oxide of Mercury. Known also as Red 
Precipitate. Used externally as a stimu- 
lant or escharotic in cases of indolent or 
flabby ulcers, in the form of wash or oint- 
ment. 

Hydrargyrum Ammoniatum or Am- 
moniated Mercury. Known also as White 
Precipitate. Used as an external applica- 
tion in the form of ointment. 

Hydrargyrum Cum Creta or Mercury 
with Chalk. A very mild mercurial simi- 
lar to, but weaker than, blue mass. Used 
in diarrhoea, and as an alterative in dis- 
eases of children. Especially indicated 
when the stools are of a whitish or clay 
color. Dose, 1 to 30 grains. 

Hydrastine. An alkaloid derived from 
hydrastis. Used to stop uterine hemor- 
rhage, and menorrhagia ; also in catarrhal 
affections of the mucous membranes. Dose, 
1-6 to y 2 grain. 

Hydrastinine Hydrochloride. The hy- 
drochloride of an artificial alkaloid derived 
from hydrastine. A cardiac tonic and nerve 
sedative. Dose, from % to \ J / 2 grains. 

Hydrastis or Golden Seal. The dried 
rhizome and roots of Hydrastis canadensis, 
found throughout the United States and 
Canada. Used in affections of the mucous 
membranes, as gastritis arising from alco- 
holic excesses, hepatic congestion, vomiting 
of pregnancy ; a local application in ca- 
tarrhal affections of the nose, ear, etc. 
Dose, 15 to 30 grains. As an application 



802 



MATERIA MEDICA. 



the proportion varies from half a flui- 
drachm to 2 fiuidrachms to an ounce of the 
diluent. 

Hyoscine Hydrobromide (Hyoscinae 
Hydrobromidum). Used in insomnia from 
overwork, acute and chronic mania. Dose, 
l-120th to l-60th of a grain. 

Hyoscyamine Hydrobromide. The hydro- 
bromide of an alkaloid obtained from hyos- 
cyamus. Properties the same as those of 
the sulphate. Dose, l-120th to l-100th of a 
grain. 

Hyoscyamine Sulphate. The sulphate 
of an alkaloid obtained from hyoscyamus. 
Used in acute mania and to dilate the pupil. 
Similar in effects to atropine. Dose, l-120th 

to l-100th of a grain. 

Hyoscyamus or Henbane. The dried 
leaves and flowering tops of Hyoscyamus 
niger, found in Europe. Used to relieve 
pain, produce sleep, and to quiet irregular 
nervous action. Indicated in hysteria, pec- 
toral diseases with cough, in hemorrhoidal 
troubles, ulcers, rheumatic swellings, and 
nervous headache. Dose of the leaves, 2 to 
5 grains. 

Infusions (Infusa). Aqueous solutions 
of vegetable products derived, without boil- 
ing, by means of hot or cold water. The 
substance is either sliced, bruised, or rarely 
powdered. When energetic or powerful 
drugs are used, the strength of the infusion 
must invariably be made upon the advice of 
a physician. 

Infusion of Digitalis (Infusum Digi- 
talis). Contains l J / 2 per cent of bruised 
digitalis, with cinnamon water as a flavor- 
ing ingredient. Dose, 2 to 4 fiuidrachms. 

Infusion of Wild Cherry (Infusum 
Pruni Virginianae). Contains 4 parts of 
powdered wild cherry bark. Dose, 2 to 3 
fluidounces. 

Compound Infusion of Senna or Black 
Draught (Infusum Sennae Composifum). 
Senna, 6 parts; Manna, 12 parts; Magne- 
sium Sulphate (Epsom Salts), 12 parts; 
Fennel,, 2 parts ; Water, 68 parts. An ex- 
cellent liquid cathartic. Dose, 4 fluidounces. 

Iodoform (Iodoformum). Obtained by 
the action of alcohol on iodine in the pres- 
ence of an alkali or alkali-carbonate. Tri- 
iodomethane, antiseptic, anaesthetic, and 
non-irritant ; used in cases of painful ulcers 
and open cancers ; a valuable dressing for 
wounds. The odor is disagreeable to some 
patients and may be disguised by oils of 
peppermint, anise, bergamot, etc. 

Iodol (Iodolum). Obtained from pyrrol 
in the presence of alcohol and iodine. Used 



for all the purposes for which iodoform is 
used ; and may be given internally for tuber- 
culosis of the larynx, laryngitis, scrofula, 
and diabetes. Dose, 2 to 4 grains. 

Iodine (Iodum). A non-metallic element 
contained in sea weeds. Employed as a 
constituent of several preparations, and 
used as an application, a bath, an injection 
into parts, enemata, and by inhalation. 

Ipecac (Ipecacuanha). The dried root of 
Cephaelis ipecacuanha, found in Brazil. In 
large doses, emetic ; in smaller doses, dia- 
phoretic and expectorant ; in still smaller 
doses, a stomach stimulant. Used in trop- 
ical dysenteries, croup, in the early stages 
of acute bronchitis, in minute doses in dys- 
pepsia. Dose, emetic, 20 to 30 grains; 
nauseating, 2 grains ; diaphoretic, 1 grain ; 
stomach stimulant, % to J / 2 grain. 

Jalap (lalapa). The dried tuberous root 
of Exogonium purga, found near Jalapa, in 
Mexico. An active cathartic producing 
copious watery discharges ; used in bilious 
fevers and congested liver. Dose of pow- 
der, 10 to 20 grains. 

Kaolin (Kaolinum). A native aluminum 
silicate. Used as an absorbent powder to 
be dusted upon irritated parts of the body. 

Kino. The inspissated juice of Ptero- 
carpus marsupium, found on the west coast 
of Africa. A powerful astringent much used 
to check morbid discharges ; in diarrhoea, 
chronic dysentery, leucorrhcea, diabetes, and 
hemorrhages of the uterus and intestines. 
Dose, 10 to 30 grains. 

Krameria or Rhataxy. The dried root 
of Krameria triandra, found in South Amer- 
ica. Tonic and powerfully astringent ; used 
in chronic diarrhoea, menorrhagia and other 
hemorrhages ; and locally in leucorrhcea, 
fissure of the anus, and prolapsus ani. Dose 
of the powder, 20 to 30 grains. 

Lactucarium. The concrete milk juice of 
the Lactuca virosa or Strong-scented Let- 
tuce, found in Europe. Anodyne and calm- 
ing in cough and nervous irritation. Dose, 

10 to 20 grains. 

Lappa or Burdock Root. The dried root 
of Arctium lappa, abundant on roadsides 
everywhere. A diuretic and diaphoretic 
alterative, used in gout, scurvy, scrofula, 
and some skin diseases. Dose, 30 to 90 
grains. 

Lard (Adeps). The prepared internal fat 
of the abdomen of the hog (Sus scrofa var. 
domesticus). Lard is emollient; but its 
chief use is as an ingredient of cerates and 
ointments. Benzoinated Lard (Adeps ben- 
soinatus) is often known as Ointment of 



MATERIA MEDICA. 



803 



Benzoin, and is an effective agent in apply- 
ing bezoin to the skin. 

Leptandra or Culver's Root. The dried 
rhizome and roots of Veronica Virginica, 
found throughout the United States. A vio- 
lent cathartic and emetic. Used by eclectics 
as a cholagogue ; also in indigestion and 
chronic constipation. Dose, 15 to 60 grains. 

Lemon Juice (Limonis Succus). Derived 
from the ripe fruit of Citrus limonum. 
Refrigerant, and, when diluted, an agreeable 
drink in fevers and inflammatory diseases ; 
also used in scurvy and acute rheumatism. 

Lemon Peel (Limonis Cortex). The 
outer rind of the ripe fruit of Citrus limo- 
num. A useful ingredient of many prepa- 
rations. 

Liniments (Linimenta). Preparations in- 
tended for external use, and permitting of 
convenient application by gently rubbing 
with the hand. 

Ammonia Liniment (Linimentum Am- 
moniae). Ammonia Water, 35 parts; Alco- 
hol, 5 parts; Cottonseed Oil, 57 parts; and 
Oleic Acid, 3 parts. An excellent rubefa- 
cient for inflammatory affections of the 
throat, for catarrhal and other pectoral com- 
plaints of children, and for rheumatic pains. 
Rub well into the part and cover with a 
piece of flannel saturated in the liniment. 
Dilute with oil, if too much inflammation 
results. 

Belladonna Liniment (Linimentum Bel- 
ladonnae). Camphor, 5 parts; Fluidextract 
of Belladonna Root, 95 parts. 

Lime Liniment or Carron Oil (Lini- 
mentum Calcis). Lime Water, 50 parts; 
Linseed Oil, 50 parts. A very useful lini- 
ment in recent burns or scalds. Smear it 
thickly on lint or cotton batting. Takes its 
popular name from the Carron iron works 
in Scotland, where it has been long used. 

Camphor Liniment (Linimentum Cam- 
phorae). Camphor, 20 parts; Cottonseed 
Oil, 80 parts. An anodyne liniment in 
sprains, bruises, rheumatism and gout of 
the joints. Allays the itching caused by 
cowhage. Camphorated oil is only half the 
strength — 1 in 10. 

Chloroform Liniment (Linimentum 
Chloroformi). Chloroform. 30 parts; Soap, 
Liniment, 70 parts. An excellent local ap- 
plication to allay pain. Cover the part with 
waxed paper or other air-tight material after 
applying, to prevent the rapid evaporation of 
the chloroform. 

Soap Liniment (Linimentum Saponis). 
Soap, dried and granulated, 6 parts ; Cam- 
phor, 4.5 parts; Oil of Rosemary, 1 part; 



Alcohol, 72.5 parts; Water, 16 parts. Much 
used as an anodyne in sprains, bruises, 
rheumatic and gouty pains. 

Liniment of Soft Soap (Linimentum 
Saponis Mollis). Soft Soap, 65 parts; Oil 
of Lavender Flowers, 2 parts ; Alcohol, 23 
parts. Called also Tincture of Green Soap. 

Turpentine Liniment (Linimentum Tere- 
binthinae). Rosin Cerate, 65 parts; Oil of 
Turpentine, 35 parts. A valuable remedy 
for burns and scalds, to be applied as soon 
as possible after the injury. Should not be 
continued after the inflammation has sub- 
sided. 

Linseed or Flaxseed (Linum). The ripe 
seed of Linum usitatissimum. Forms an 
excellent emollient poultice. 

Liquores (Solutions). Aqueous solutions 
of medicinal agents without the use of 
sugar. They differ from infusions in that 
all of the substance is soluble in liquores ; 
and from waters (aquae) in that the dis- 
solved substances are neither gaseous nor 
very volatile. 

Solution of Arsenous Acid (Liquor 
Acidi Arsenosi). Arsenic Trioxide, 1 part; 
Diluted Hydrochloric Acid, 5 parts ; Water, 
96 parts. Contains 4.5 grains of arsenous 
acid to the fluidounce, or 1 per cent of 
arsenic trioxide. Medicinal properties are 
the same as those of Fowler's Solution. 
Dose, 2 to 8 minims. 

Solution of Ammonium Acetate, or 
Spirit of Mindererus (Liquor Ammonii 
Acetatis). Ammonium Carbonate, 5 grammes ; 
Diluted Acetic Acid, 100 cubic centimeters. 
Contains 7 per cent of ammonium acetate. 
A feeble diaphoretic. Dose, J / 2 to \y 2 fluid- 
ounces. 

Antiseptic Solution (Liquor Antisep- 
ticus). Boric Acid, 2 parts; Benzoic Acid, 
0.1 part; Thymol, 0.1 part; Eucalyptol, 0.025 
part ; Oil of Peppermint, 0.05 part ; Oil of 
Gaultheria, 0.025 part; Oil of Thyme, 0.01 
part; Alcohol, 25 parts; Purified Talc,. 2 
parts; Water, to make 100 parts. A pleas- 
ant tasting, feeble antiseptic used as a mouth 
wash, and as an application to wounds and 
cuts. 

Solution of Arsenous and Mercuric 
Iodides or Donovan's Solution (Liquor 
Arseni et Hydrargyri Iodidi). An aqueous 
solution containing 1 per cent of arsenous 
iodide and 1 per cent of mercuric iodide. 
An alterative in skin diseases, such as pso- 
riasis, impetigo, porrigo, lepra, pityriasis, 
lupus ; also for the "night pains" of rheuma- 
tism. Dose, 1 to 5 minims. 

Lime Water or Solution of Calcium 
Hydroxide (Liquor Calcis). A saturated 



804 



MATERIA MEDICA. 



solution containing not less than 0.14 per 
cent of pure calcium hydroxide (slaked 
lime). An antacid, tonic, and astringent; 
used in dyspepsia accompanied by acidity 
of the stomach, diarrhoeas, and diabetes, 
nausea, vomiting. Dose, 1 to 4 fluidounces. 

Chlorine Water, Compound Solution of 
Chlorine (Liquor Chlori Compositus). 
Made by saturating water with chlorine gas ; 
contains not less than 0.4 per cent of chlo- 
rine. Dose, 1 to 4 fluidrachms. 

Compound Solution of Cresol (Liquor 
Cresolis Compositus). An antiseptic solu- 
tion which mixes with water. Surpasses 
phenol (carbolic acid) as a germicide or 
destroyer of micro-organisms. Dose, 1 to 2 
minims. 

Solution of Ferric Chloride (Liquor 
Ferri Chloridi). An aqueous solution of 
ferric chloride, containing not less than 29 
per cent of the anhydrous salt. A styptic, 
injected into aneurisms; for stopping hem- 
orrhages. Dose, 1 to 5 minims. 

Solution of Iron and Ammonium Ace- 
tate, Basham's Mixture (Liquor Ferri et 
Ammonri Acetatis). An active chalybeate 
and astringent, much used in chronic Bright's 
disease. Dose, % to J / 2 fluidounce. 

Solution of Ferric Subsulphate, Mon- 
sel's Solution (Liquor Ferri Sub sulphatis). 
A powerful astringent, styptic ; much used 
in hemorrhage from the stomach or bowels. 
Dose, 3 to 6 minims, well diluted. 

Solution of Ferric Sulphate (Liquor 
Ferri Sub sulphatis). A powerful astringent 
but limited in its uses on account of its 
marked irritant characteristics. Ferric hy- 
droxide, the great antidote for arsenic is 
made from it. 

Solution of Formaldehyde (Liquor For- 
maldehydi). Contains not less than 37 per 
cent of weight of absolute formaldehyde. 
A powerful germicide, higher than phenol 
(carbolic acid), but lower than corrosive 
sublimate. Generally used as a disinfecting 
agent. 

Solution of Mercuric Nitrate (Liquor 
Hydrargyri Nitratis). Contains about 60 
per cent of mercuric nitrate. A caustic 
application to cancers, lupus, acne, boils, 
etc. Never used internally. 

Compound Solution of Iodine, Lugol's 
Solution (Liquor Iodi Compositus). Con- 
tains not less than 5 per cent of iodine and 
10 per cent of iodide of potassium. Medi- 
cinally useful for the iodine which it con- 
tains. Dose, 5 minims in water or milk to 
prevent irritation of the stomach. 

Solution of Magnesium Citrate (Liquor 



Magnesii Citratis). A cooling cathartic 
which operates mildly. Dose as a purge, 12 
fluidounces ; as a laxative, 6 fluidounces. 

Solution of Lead Subacetate, Goulard's 
Extract (Liquor Plumb i Subacetatis). Con- 
tains not less than 25 per cent of lead sub- 
acetate. Astringent, used only externally 
on sprains, bruises, burns, blisters, etc. Ap- 
plied on saturated linen cloths, changed as 
fast as they become dry. 

Solution of Potassium Arsenite, Fow- 
ler's Solution (Liquor Potassii Arsenitis). 
Contains the equivalent of 1 per cent of 
arsenic trioxide. Used in intermittent fever, 
chorea, nervous diseases with debility, mala- 
rial affections, and skin diseases. Dose, 
3 to 5 minims. 

Solution of Potassium Citrate, Neu- 
tral Mixture (Liquor Potassii Citratis). 
This effervescing draught is much used in 
cases of malarial, intermittent, and other 
fevers attended by marked irritability of the 
stomach. Dose, 4 fluidrachms. 

Solution of Potassium Hydroxide 
(Liquor Potassii Hydroxidi), An antacid, 
diuretic, and antilithic, formerly much used, 
but its place is now taken by carbonated 
alkalies. Dose, 10 to 30 minims. 

Solution of Chlorinated Soda, Labar- 
raque's Solution (Liquor Sodae Chlori- 
natae). Applied locally to infected wounds 
or ulcers, and to cavities which may be 
reached from the outside. Diluted in such 
cases with from 15 to 30 parts of water. 

Solution of Sodium Arsenate (Liquor 
Sodii Arsenatis). An official form for the 
administration of sodium arsenate. Dose, 
3 to 5 minims. 

Solution of Sodium Hydroxide (Liquor 
Sodii Hydroxide). Dose, 10 to 30 minims. 

Compound Solution of Sodium Phos- 
phate (Liquor Sodii Phosphatis Composi- 
tus). Used the same as sodium phosphate. 
Dose, 1 to 2 fluidrachms. 

Solution of Zinc Chloride (Liquor 
Zinci Chloridi). An excellent disinfectant 
for ships, hospitals, water-closets, etc. De- 
stroys putrid odors, and possesses no odor. 
A pint is mixed with four gallons of water 
for disinfecting on a large scale. Applied 
in weak solution to ulcers and as an injec- 
tion in inflammatory conditions. Burnett's 
disinfecting fluid is also an aqueous solution 
of zinc chloride. 

Lithium Benzoate. Made by decompos- 
ing lithium carbonate with benzoic acid. A 
remedy against gout. Dose, 15 to 30 grains. 



MATERIA MEDICA. 



805 



Lithium Bromide. Introduced into medi- 
cine by S. Weir Mitchell. It is more hyp- 
notic than other bromides. Dose, 15 to 30 
grains. 

Lithium Carbonate. Has an extraor- 
dinary solvent power over uric acid in the 
system. Very valuable in cases of gout and 
gouty diathesis ; also acts as a diuretic. 
Dose, 5 to 15 grains. 

Lithium Citrate. Acts in the same way 
as lithium carbonate, into which it is 
changed in the system. Its chief advantage 
lies in its less unpleasant taste, and less irri- 
tating effects upon the stomach. Dose, 10 
to 30 grains. The effervescent citrate is a 
still more agreeable form, and is given in 
doses of 2 drachms in solution. 

Lithium Salicylate. Unites the medi- 
cinal properties of lithium and salicylic 
acid. It is better than salicylic acid in that 
it is freely soluble in water and less irritat- 
ing to the stomach. Used effectually in 
gout and rheumatism. Dose, 20 to 40 grains. 

Lobelia. The dried leaves and tops of 
Lobelia inflata, found throughout the eastern 
states and Canada. Used in spasmodic 
asthma, catarrh, croup, whooping cough ; 
but chiefly in bronchial spasm. Great cau- 
tion is necessary in its use. Best given as 
the tincture. Dose of the plant as an anti- 
spasmodic, 5 grains. 

Lupulin. Glands derived from the fruit 
of Hamulus lupuhts, or Hop. See Hops. 

Lycopodium. The spores of Lycopodium 
clavatum and other species ; known as Club 
Moss, a native of Europe, Asia, and America. 
It is a fine, pale yellow powder. Used as 
a dusting powder on excoriated surfaces, as 
the chafing of infants ; as a coating for pills 
to prevent adhesion and massing together. 
It burns with a quick flash when thrown 
on flame. 

Magnesium Carbonate. The official mag- 
nesium carbonate of the U. S. P. corre- 
sponds very nearly with the Light Magne- 
sium Carbonate (Magnesii Carbonas Levis) 
of the British. It is a very light, white, 
inodorous powder. Antacid and laxative ; 
used under the name of calcined magnesia 
in dyspepsia, sick headache, gout, and cases 
of sour stomach and constipation. Dose as 
a laxative, 30 grains to 1 drachm ; as an 
antacid or antilithic, 10 to 30 grains. The 
heavy oxide (Magnesii oxidum ponderosum) 
is also official. Dose, 30 to 60 grains. 

Magnesium Sulphate or Epsom Salt. 
An active and safe cathartic ; operates with 
very little pain or nausea and watery dis- 
charges. On account of its cooling and 



refrigerant effects it is used in fevers, in- 
flammatory affections, colic, and obstinate 
constipation. The medium dose is 1 ounce. 
Often combined with senna, as it tends to 
prevent griping effects of other cathartics. 
Dose, 1 to 8 drachms. It is also adminis- 
tered as the Effervescing Magnesium Sul- 
phate, a less disagreeable form. 

Manganese Dioxide, Precipitated. Tonic 
and alterative ; used in amenorrhcea, chlo- 
rosis, scurvy, and some skin diseases, such 
as itch and porrigo. Also beneficial in sto- 
machic pains of nervous origin. It is supe- 
rior to bismuth, because it does not consti- 
pate. Dose, 3 to 5 grains. 

Manganese Hypophosphite. Similar in 
use to Calcium Hypophosphite (which see). 
Dose, 3 to 5 grains. 

Manganese Sulphate. Tonic, rarely 
given. Dose, 5 to 20 grains. 

Manna. The concrete or solid exudation 
of Fraxinus ornus or Flowering Ash, a 
native of southern Italy, cultivated else- 
where. A gentle laxative, often prescribed 
with other purgatives, such as senna, rhu- 
barb, magnesia. Dose for children, 1 to 4 
drachms, given in water or an aromatic in- 
fusion. Dose, Yi to 1 ounce. 

Marrubium or Horehound. The dried 
leaves and flowering tops of Marrubium 
vulgare or white horehound (hoarhound), 
a native of Europe but naturalized in 
America. Tonic, and, in large doses, laxa- 
tive. Employed in catarrh and chronic 
affections of the lungs attended with cough 
and free expectoration. Often given in 
wineglass doses of an infusion made from 
1 ounce of the herb to a pint of boiling 
water. Dose of the herb, 30 grains to 1 
drachm. 

Mass of Ferrous Carbonate, Vallet's 
Mass. A soft pilular mass with a strong 
iron taste, containing 50 per cent of fer- 
rous carbonate by weight. An excellent 
preparation in anaemia and chlorosis. Does 
not deteriorate quickly, is not astringent, 
and is readily soluble in acids. Dose, in 
pills, from 3 to 5 grains after meals. 

Mass of Mercury, Blue Mass or Blue 
Pill. One of the mildest of the mercurials ; 
used as a sialagogue and alterative. Dose 
as a laxative, 5 to 15 grains. 

Mastiche or Mastic. A solid resinous 
exudation of Pistacia lentiscus, a native of 
Mediterranean countries. Scarcely ever 
given internally except as in the form of 
Pill of Aloes and Mastic. Used for filling 
teeth, and applied externally as a styptic in 
bleeding at the nose, etc. 



8o6 



MATERIA MEDICA. 



Matico. The leaves of Piper angustifo- 
1 in m, found in the tropics. Feebly astrin- 
gent and stimulant ; effects upon the urinary- 
organs are similar to those of cubebs. Used 
also in diarrhoea and dysentery, and as a 
local haemostatic. Dose, 45 to 75 grains. 

Matricaria or German Chamomile. The 
dried flowers of Matricaria chamomilla, a 
native of Europe, and cultivated in North 
America. A mild tonic, in very large doses 
an emetic. Dose, Y> ounce. 

Mel or Honey. Used in medicine as a vehi- 
cle ; especially as a demulcent in gargles. 
Clarified honey (Mel depuratum) enters 
into composition in several pharmaceutical 
preparations. Dose, 1 to 4 fluidrachms. 

Mel Rosae (Honey of Rose). A pleasant 
addition to gargles for inflammation of the 
mouth and throat and in ulceration. Dose, 
1 fluidrachm. 

Mel Boracis (Honey of Borax). Borax, 
12.5 parts; Glycerine, 6.25 parts; Clarified 
Honey, 81.25 parts. Used in thrush of 
infants and in aphthous ulceration of the 
mouth. 

Mentha Piperita (Peppermint). The 
dried leaves and tops of Mentha piperita, 
cultivated extensively. An aromatic stimu- 
lant used in nausea, spasmodic pains of the 
stomach and bowels, flatus, and as an adju- 
vant to disagreeable and nauseous medi- 
cines. Dose, 1 drachm. 

Mentha Viridis (Spearmint). The dried 
leaves and tops of Mentha spicata, native of 
Europe, but naturalized throughout America. 
Medicinally the same as peppermint. Dose, 
1 drachm. 

Menthol. A secondary alcohol obtained 
from the oil of peppermint. When the oil 
of peppermint is cooled to a very low tem- 
perature, the menthol crystallizes out. 
Menthol acts upon the sensory nerves as a 
paralyzant ; is a germicide and resembles 
phenol (carbolic acid) in its effects. Used 
externally as a local anaesthetic for the re- 
lief of neuralgic pains, toothache, and sci- 
atica ; also useful in inflammation of the 
mouth and throat. Dose, 1 to 2 grains. 

Methyl Salicylate. The principal con- 
stituent of oil of gaultheria and oil of 
betula. Similar in effects to the Oil of 
Gaultheria (which see). Dose, 15 to 30 
minims. 

Methylthionine Hydrochloride or 
Methylene Blue. A synthetic dye color 
obtained from aniline. It is not the same 
as methyl blue, which is limited to external 
use as an antiseptic. Methylene blue is ab- 



sorbed and eliminated by the kidneys color- 
ing the urine blue. A feeble antiseptic em- 
ployed in urinary diseases; an analgesic in 
neuralgia; and useful in malaria. Dose in 
capsule, 2 to 5 grains. 

Mezereum. The dried bark of Daphne 
mezereum, a native of Europe and western 
Asia. The fresh bark is used as a vesicant 
or epispastic ; the dried bark is less power- 
ful. An irritant ointment applied to indo- 
lent ulcers is composed of mezereum bark, 
lard, and yellow wax. 

Misturae or Mixtures. Preparations 
of insoluble substances suspended in fluids 
by the action of gum arabic, sugar, yolk of 
egg. When oil is used the mixture is more 
properly an emulsion. 

Mistura Cretae or Chalk Mixture. 
Composed of Compound Chalk Powder, 20 
parts ; Cinnamon Water, 40 parts ; Water, 
40 parts. Employed in looseness of the 
bowels attended by acidity of the stomach. 
Dose, 4 fluidrachms. 

Compound Iron Mixture or Griffith's 
Mixture (Mistura Ferri Composita). A 
good tonic in debility of the digestive or- 
gans, especially when attended by menstrual 
irregularities ; used in hysteria and chloro- 
sis ; also in the hectic fever of phthisis and 
chronic catarrh. Dose, x / 2 to 2 fluidounces. 

Compound Mixture of Glycyrrhiza or 
Brown Mixture (Mistura Glycyrrhiza Com- 
posita). ' 

Mixture of Rhubarb and Soda (Mistura 
Rhei et Sodae). Given to children as a 
stomachic and carminative. Dose, Y to 1 
fluidrachm. 

Morphine. An alkaloid obtained from 
opium, of which it is the chief narcotic 
principle. It is insoluble in water in its 
pure state, consequently its soluble salts are 
preferred. The acetate, sulphate, and hydro- 
chloride are employed and possess similar 
medicinal effects. Dose, 1-5 of a grain, 
which is equal to 1 grain of opium. 

Morphine Acetate. Identical in medi- 
cinal value to the other salts of morphine, 
and are given by the mouth in pill form; 
administered hypodermically and applied ex- 
ternally. Dose, Y% to y 2 grain. 

Morphine Hydrochloride. Called Mor- 
phine Hydrochlorate in the old edition of 
the Pharmacopoeia. Not used in America 
so much as are the other salts, but more 
frequently used in Europe. Dose, ^ to ^ 
grain. 

Morphine Sulphate. Dose, Y to y 2 
grain. 



MATERIA MEDICA. 



807 



Moschus or Musk. The dried secretion 
of the preputial follicles of the Moschus 
moscJiiferus or the musk-deer of the moun- 
tainous regions of Central Asia. A stimu- 
lant and antispasmodic ; valuable in the 
treatment of nervous exhaustion following 
the crisis of acute diseases ; typhus, typhoid, 
pneumonia of drunkards, and in obstinate 
hiccough. Dose, 5 to 15 grains. 

Mucilagines (Mucilages). An aqueous 
solution of gum or of gummy substances. 

Mucilage of Acacia. Employed chiefly 
in making pills and in suspending insoluble 
substances. 

Mucilage of Sassafras Pith (Mucilago 
Sassafras Medullae). Much used as an 
application to the eye in conjunctivitis ; also 
as a demulcent drink in inflammation of the 
mucous membranes. 

Mucilage of Tragacanth. Used in mak- 
ing pills and troches ; mixed with glycerine 
it is an excellent excipient. 

Mucilage of Elm (Mucilago Ulmi). A 
demulcent drink in catarrhal and nephritic 
diseases. An emollient application to boils, 
carbuncles, and in dermatitis and erysipelas. 

Myristica or Nutmeg. The kernel of 
the ripe seed of Myristica fragrans, found 
in the Moluccas and adjacent islands. It is 
an aromatic possessing some narcotic prop- 
erties. It covers the taste of disagreeable 
medicines. Dose, 5 to 20 grains. 

Myrrha or Myrrh. A gum resin ob- 
tained from Commiphora myrrha of Arabia. 
A stimulant tonic used in dyspepsia, debility, 
chronic catarrh, pectoral affections, chlorosis, 
amenorrhcea, spongy or sore gums, and 
aphthous sore mouth of children. Dose, 
10 to 30 grains. 

Naphthalene. A hydrocarbon obtained 
from coal tar, sometimes called tar camphor. 
Antiseptic, vermifuge in seat-worms, tseni- 
cide in tape-worms, expectorant in chronic 
bronchitis ; used in intestinal catarrh, intes- 
tinal inflammation, typhoid fever ; exter- 
nally as an antiseptic dressing, and in the 
treatment of several skin diseases. Dose in 
powder, 1 to 3 grains. 

Nux Vomica. The dried ripe seeds of 
Strychnos nux-vomica, a tree found in the 
East Indies. The two principal active prin- 
ciples in the seeds are the alkaloids, strych- 
nine and brucine. Its effects are the same 
as those of Strychnine (which see). Dose, 
1 to 4 grains. 

Olea or Oils. Oils are liquid or solid 
substances with the characteristic oily sen- 
sation to the touch, are inflammable, and 



leave a gray or oily stain or trace upon 
paper. They are classified as Fixed Oils 
and Volatile»Oils. 

Fixed Oils are fats or fatty oils which 
form a large part of the animal and vege- 
table fats. The vegetable fixed oils are 
derived almost wholly from the fruits of 
plants. 

1. The Olive Oil group includes the vege- 
table non-drying oils derived from the 
almond, peach, apricot, bean, earthnut, and 
the olive. 

2. Rape Oil group, less non-drying than 
the oils of Group 1. These are all de- 
rived from the Cruciferae, and are the 
oils of colza, rape seed, black mustard, and 
white mustard. 

3. Cottonseed Oil group undergoes more 
or less drying on exposure to the air, and 
includes beechnut, cottonseed, hazelnut, 
sesame or teel, sunflower, camelina, and 
cress seed. 

4. Linseed Oil group, vegetable drying 
oils, which are converted in solid masses 
on exposure to the air. It includes niger 
seed, hemp seed, linseed, poppy seed, Scotch 
fir seed, tobacco seed, walnut, and weld 
seed. 

5. Castor Oil group is denser and of 
thicker consistency than other oils. It in- 
cludes castor, croton, Chinese wood, boiled 
linseed, and the blown oils. 

6. Palm Oil group includes such solid vege- 
table fats as palm oil, cacao butter, nutmeg 
butter, and shea butter. 

7. Cocoanut Oil group contains very 
marked quantities of the glycerides, and in- 
cludes cocoanut oil, palm-nut oil, laurel oil, 
Japan wax, and myrtle wax. 

8. Lard Oil group or animal oleins are 
fluid at ordinary temperatures and are ob- 
tained from terrestrial animals : bone oil, 
lard oil, tallow oil, and neat's-foot oil. 

9. Tallow Oil group of solid animal fats 
such as bone fat, butter fat, butterine, oleo- 
margarine, hog's lard, horse fat, beef tallow, 
mutton tallow, and wool fat. 

10. Whale Oil group of marine animal 
oils derived from fish and whales. Train 
oil is the class of oils from the whale, seal, 
shark, cod. Others of the group are cod- 
liver, menhaden, and porpoise. 

11. Sperm Oil group, liquid waxes, such 
as sperm oil, bottlenose oil, and dolphin oil. 

12. Spermaceti group, waxes proper: 
beeswax, Brazil wax, Chinese wax, myrtle 
wax, ocuba wax, palm wax, and spermaceti. 

Volatile Oils, distilled oils, or essential 
oils are found in all odoriferous plants. 



8o8 



MATERIA MEDICA. 



The odor is strong, resembling that of the 
plant from which the oil is obtained ; the 
taste is pungent, and, when diluted, often 
agreeably aromatic. The greater number of 
volatile oils are lighter than water. They 
are classified into : — 

1. Alcohols and their esters. 

2. Aldehydes. 

3. Ketones. 

4. Acids and their esters. 

5. Phenols and Phenol Ethers. 

6. Neutral Bodies, Oxides, etc. 

7. Sulphides and Sulphur Compounds. 

Oleum Adipis or Lard Oil. A fixed oil 
expressed at a low temperature from lard. 
Used wholly for pharmaceutical purposes. 

Oleum Aetherium or Ethereal Oil. A 
volatile liquid consisting of equal parts of 
heavy oil of wine and ether. Used in the 
preparation of Compound Spirit of Ether. 

Oleum Amygdalae Amarae or Oil of 
Bitter Almonds. A volatile oil obtained 
from bitter almond seeds. Used to conceal 
the disagreeable taste of cod-liver and cas- 
tor oil. Dose, %. to 1 minim. 

Oleum Amygdalae Expressum or Ex- 
pressed Oil of Almond. A fixed oil 
expressed from the seeds of bitter or sweet 
almond. Used the same as olive oil ; as 
demulcent in pectoral troubles with cough ; 
forms an agreeable emulsion. Dose, 1 flui- 
drachm to 1 fluidounce. 

Oleum Anisi or Oil of Anise. A vola- 
tile oil distilled from anise fruit. Dose, 3 

to 5 minims. 

Oleum Aurantii Corticis or Oil of 
Orange Peel. A volatile oil expressed from 
the fresh peel of the orange. Used only for 
flavoring purposes. Dose, 3 to 5 minims. 

Oleum Betulae or Oil of Betula or Oil 
of Sweet Birch. A volatile oil derived by 
distillation from the bark of Betula lenta or 
Sweet Birch. It is generally sold as the 
oil of wintergreen (oil of gaultheria), from 
which it differs very slightly. Dose, 5 to 30 
minims. 

Oleum Cadinum or Oil of Cade or Oil 
of Juniper Tar. Obtained by dry distilla- 
tion from the heart-wood of Juniperus oxy- 
cedrus, found in Mediterranean countries. 
Used locally in chronic eczema, psoriasis, 
and other skin diseases. Rarely used inter- 
nally, its effects resembling those of oil of 
tar. Dose, 1 to 3 minims. 

Oleum Cajuputi or Oil of Cajuput. A 
volatile oil distilled from the fresh leaves 
of Melaleuca leucadendron, found in the 
Moluccas and adjacent islands. Prescribed 
internally in chronic rheumatism, spasmodic 



affections of the stomach and bowels with- 
out inflammation, cholera, low fevers, tooth- 
ache, dyspepsia, chronic laryngitis, and 
bronchitis, catarrh of the bladder, skin dis- 
eases, especially acne rosacea. Dose, 3 to 
10 minims. 

Oleum Cari or Oil of Caraway. A vola- 
tile oil distilled from the seeds of Carum 
carvi. Used to cover the taste of disagree- 
able and nauseating medicines, and to pre- 
vent griping effects of purgatives. Dose, 1 
to 10 minims. 

Oleum Caryophylli or Oil of Cloves. 
A volatile oil distilled from cloves. A pow- 
erful local narcotic used for toothache ; re- 
sembles phenol in its therapeutical effects; 
used as an antiseptic and antipyretic. Dose, 

2 to 6 minims. 

Oleum Chenopodii or Oil of Worm- 
seed. A volatile oil distilled from Cheno- 
podium anthelminticum. Used as an anthel- 
mintic ; given morning and evening for 
three or four days and followed by a cathar- 
tic. Dose, 2 to 6 minims. 

Oleum Cinnamomi or Oil of Cinnamon 
or Oil of Cassia. A volatile oil distilled 
from Cassia cinnamon. Cordial and car- 
minative without astringency ; used to cor- 
rect or conceal the disagreeable qualities of 
other medicines. Dose, 1 to 3 minims. 

Oleum Copaibae or Oil of Copaiba. A 
volatile oil distilled from Copaiba. Effects 
are the same as those of Copaiba. Dose, 5 
to IS minims. 

Oleum Coriandri or Oil of Coriander. 
A volatile oil distilled from Coriander. A 
correcting and concealing adjuvant. Dose, 

3 minims. 

Oleum Cubebae or Oil of Cubeb. A 
volatile oil distilled from Cubeb. Dose, 5 
to 15 minims. 

Oleum Erigerontis or Oil of Erigeron. 
A volatile oil distilled from Erigeron cana- 
dense. Used by eclectics in diarrhoea, dys- 
entery, hemorrhages, haemoptysis, diarrhoea 
of debility, and hemorrhage of the bowels 
in typhoid fever. Dose, 10 minims to ^ 
fluidrachm. 

Oleum Eucalypti or Oil of Eucalyptus. 
A volatile oil distilled from the fresh leaves 
of Eucalyptus. Dose, 10 to 15 minims. 

Oleum Foeniculi or Oil of Fennel. A 
volatile oil distilled from Fennel. Dose, 3 
to 5 minims. 

Oleum Gaultheriae or Oil of Winter- 
green. A volatile oil distilled from the 
leaves of Gaultheria procumbens. Used for 



MATERIA MEDICA. 



809 



its flavor, as a substitute for salicylic acid. 
Dose, 15 to 30 minims. 

Oleum Gossypii Seminis or Cotton- 
seed Oil. A fixed oil expressed from the 
seeds of Gossypium herbaceum. Used as an 
adulterant of olive oil, and in many lini- 
ments. Dose, 2 to 6 fluidrachms. 

Oleum Hedeomae or Oil of Penny- 
royal. A volatile oil distilled from the 
leaves and flowering tops of Hedeoma. Used 
in flatulent colic, sick stomach, amenorrhoea, 
and as a corrective. Dose, 2 to 10 minims. 

Oleum Juniperi or Oil of Juniper. A 
volatile oil distilled from the fruit of Juni- 
perus communis. Stimulant, carminative, 
diuretic, and useful in dropsy. Holland gin 
owes its properties to this oil. Dose, 5 to 
15 minims. 

Oleum Lavandulae Florum or Oil of 
Lavender Flowers. A volatile oil distilled 
from the fresh flowering tops of Lavandula 
officinalis. Dose, 1 to 6 minims. 

Oleum Limonis or Oil of Lemon. A 
volatile oil expressed from fresh Lemon 
Peel. Has stimulant and aromatic proper- 
ties, but chiefly used as a flavoring agent. 
Dose, 3 to 6 minims. 

Oleum Lini or Linseed Oil. A fixed 
oil expressed from Linseed. Laxative in the 
dose of a fluidounce. Two fluidounces of 
the oil night and morning are recommended 
for piles. Dose, 1 to 2 fluidounces. 

Oleum Menthae Piperitae or Oil of Pep- 
permint. A volatile oil distilled from the 
fresh or partly dried leaves and flowering 
tops of Peppermint. Stimulating, carmina- 
tive ; used in flatulence, nausea, spasmodic 
pains in stomach and bowels. An external 
remedy for neuralgia of great value when 
applied on a saturated cloth. A useful ano- 
dyne counterirritant in rheumatism. Dis- 
solved in alcohol it is known as Essence of 
Peppermint. Dose, 2 to 10 minims. 

Oleum Menthae Viridis or Oil of 
Spearmint. A volatile oil distilled from 
the fresh or partly dried leaves and flower- 
ing tops of Spearmint. Its uses are the 
same as those of Peppermint. Dose, 2 to 
6 minims. 

Oleum Morrhuae or Cod-Liver Oil. A 
fixed oil obtained from the fresh livers of 
Gadus morrhua. Used in rheumatism, 
strumous diseases, scrofula, diseases of the 
joints, carious ulcers, rickets, phthisis, 
cutaneous diseases, and of supreme value in 
pulmonary consumption. Dose, 4 fluidrachms. 

Oleum Myristicae or Oil of Nutmeg. 
A volatile oil distilled from nutmeg. Dose, 
5 to 10 minims. 



Oleum Olivae or Olive Oil. A fixed oil 
expressed from the ripe fruit of Olea Euro- 
poea. Nutritious, mildly laxative, valuable 
in large doses in gallstones ; a constituent 
of ointments, liniments, cerates, and plas- 
ters. Dose as a laxative, 1 to 2 fluidounces. 

Oleum Picis Liquidae or Oil of Tar. 
A volatile oil distilled from tar. Dose, 1 to 
5 minims. 

Oleum Pimentae or Oil of Pimenta or 
Allspice. A volatile oil distilled from 
Pimenta. A stimulant aromatic oil. Dose, 
3 to 6 minims. 

Oleum Ricini or Castor Oil. A fixed 
oil expressed from the seed of Ricinus com- 
munis. A mild, speedy cathartic operating 
with slight uneasiness ; valuable in constipa- 
tion, colic, diarrhoea, dysentery, enteritis ; 
the best and safest cathartic for children. 
Dose for an infant, 1 to 3 or 4 fluidrachms 
(relatively larger than for adults) ; for 
adults, from y 2 an ounce to 2 fluidounces. 

Oleum Rosae or Oil of Rose. A vola- 
tile oil distilled from the fresh flowers of 
Rosa, damascena. Called also the attar, otto 
or essence of roses. Prepared on a large 
scale in Turkey. A grateful perfume ; added 
to many preparations, cerates, and oint- 
ments. 

Oleum Rosmarini or Oil of Rosemary. 
A volatile oil distilled from the fresh flow- 
ers of Rosmarinus- officinalis. Sometimes 
adulterated with oil of turpentine. A stim- 
ulant, but chiefly used as an ingredient of 
rubefacient liniments. Dose, 3 to 6 minims. 

Oleum Sabinae or Oil of Savine. A 
volatile oil distilled from the fresh trips of 
Savine. A powerful local irritant ; used as 
a cure for alopecia in the strength of 5 to 
30 minims in 1 ounce of alcohol rubbed on 
the head. 

Oleum Santali or Oil of Sandalwood. 
A volatile oil distilled from the wood of 
Santalum album. A perfume ; a useful 
remedy for chronic inflammation of the 
mucous membranes in bronchitis. Dose, 15 
to 20 minims. 

Oleum Sassafras or Oil of Sassafras. 
A volatile oil distilled from the root and 
root bark of Sassafras variifolium. Used as 
a flavoring agent ; has medicinal properties 
similar to those of oil of cloves and other 
aromatic oils. Dose, 3 to 6 minims. 

Oleum Sinapis Volatile or Volatile 
Oil of Mustard. A volatile oil distilled 
from Black Mustard seed. Used in mak- 
ing sinapisms (mustard papers for counter- 
irritants). Never given internally. 



8io 



MATERIA MEDICA. 



Oleum Terebinthinae or Oil of Tur- 
pentine. A volatile oil distilled from tur- 
pentine and commonly called Spirits of 
Turpentine. A stimulant, diuretic, diapho- 
retic, anthelmintic, in large doses cathartic ; 
externally, rubefacient. Dose, 5 to 30 
minims. 

Oleum Theobromatis or Cacao Butter. 
A fixed oil expressed from the roasted seeds 
of Theobroma cacao. An ingredient of cos- 
metic ointments, also used for coating pills 
and for making suppositories. 

Oleum Thymi or Oil of Thyme. A 
volatile oil distilled from the leaves and 
flowering tops of Thymus vulgaris. An in- 
ferior oil made from wild thyme is called 
Oil of Origanum. An antiseptic, and a dif- 
fusible stimulant in collapse. Dose, 3 to 5 
minims. 

Oleum Tiglii or Croton Oil. A fixed 
oil expressed from the seeds of Croton 
tiglium, a small tree or shrub found native 
in Hindostan, Ceylon, the Moluccas. A 
powerful drastic purgative, acts with great 
rapidity, frequently within an hour from 
taking, and with much discomfort. A drop 
placed upon the tongue of an insensible 
person will generally operate. Used in ob- 
stinate constipation. Applied externally in 
rheumatism, neuralgia, laryngeal and pul- 
monary diseases, but must be greatly diluted. 
Applied to the skin it produces inflammation 
of the parts, and sometimes acts as a blis- 
tering fluid. Dose, ^ to 2 minims. 

Opium. The solid exudation obtained from 
the unripe capsules of Papaver somniferum 
of India. A stimulant narcotic producing 
sleep in half an hour after a dose is taken. 
Under" its influence pain is allayed and 
nervous irritation ceases. In its first effects 
it is an excitant; and is given in low fevers 
and typhoid fever ; opium is also the most 
effectual analgesic, and is given by mouth 
or as a hypodermic injection of one of its 
salts ; in sleeplessness due to pain it is one 
of the most useful drugs of its kind ; as an 
antispasmodic it is beneficial in lockjaw, 
colic, and convulsions ; it allays cough, 
nausea, and stops internal hemorrhages ; it 
checks the discharges of diarrhoeas and 
diabetes ; with ipecac it acts as a diaphoretic 
in colds, rheumatism, grippe, etc. Dose, 
1 to 2 grains. 

Pancreatin. Obtained from the pancreas 
of the hog or ox. It is used as a ferment 
in dyspepsia, and as a means of a predigest- 
ing food. Dose, 7 J / 2 to 15 grains. 

Paraffine. A solid mixture of hydro- 
carbons obtained from the distillates of 
petroleum. It is used in the manufacture 



of candles ; as a preservative of meats and 
preserves ; as a basis of chewing gum, and 
for coating pills. 

Paraldehyde. Obtained from aldehyde 
by the action of acids or some salts. A 
mild hypnotic in insomnia of neurasthenia; 
and of use in asthma. Dose, J / 2 to \y 2 
fluidrachms. 

Pareira. The dried root of Chondroden- 
dron tomentosum, found in Brazil. Tonic, 
aperient, and diuretic ; useful in calculous 
affections, chronic inflammation of the kid- 
neys and bladder, leucorrhoea, dropsy, 
rheumatism, and jaundice. Dose, 30 to 60 
grains. 

Pelletierine Tannate. A mixture of 

the tannates of four alkaloids found in 

Punica granatum. A useful medicine in 
cases of tape-worm. Dose, 4 grains. 

Pepo or Pumpkin Seed. The ripe seed 
of Cucurbita pepo or common pumpkin. It 
is given in cases of tape-worm. The patient 
takes a light supper of bread and milk; in 
the morning an ounce and a half of the 
seeds, with no food until 10 a. m. Dose, 
1 to 2 ounces. 

Pepsin. A ferment obtained from the 
fresh stomach of the hog. Used in cases 
of indigestion. Dose, 10 to 15 grains. 

Petrolatum or Vaseline. A mixture of 
hydrocarbons obtained from the residue of 
petroleum after the lighter and more vola- 
tile constituents have been distilled off. It 
has a number of trade names, such as 
Petroleum Jelly, Cosmoline, Petroleum Oint- 
ment, etc. A bland protective dressing, an 
ingredient of ointments, and given inter- 
nally to soothe irritations in 3-grain pills. 
In doses of from 1 to 4 drachms it acts as 
a laxative and emollient. White petrolatum 
is colorless. Liquid petrolatum is called 
albolene, and glycoline, and is used as a 
soothing application to the mucous mem- 
brane of the nose, throat, and larynx by 
means of an atomizer. 

Phenol or Carbolic Acid. Obtained by 
fractional distillation from coal tar or made 
synthetically. A powerful irritant and local 
anaesthetic ; a fatal and rapidly acting poi- 
son. It may be given internally for nerv- 
ous vomiting and diarrhoeas of irritation. 
Externally it is a germicide of service in 
cases of infection and in antiseptic surgery. 
A 2 per cent solution is applied to burns, 
ulcerations, infected wounds, carbuncles, 
boils, and glandular swellings. The same 
strength is useful in sanitary disinfection. 
In burns and scalds 1 part of phenol and 6 
parts of olive oil may be applied with lint. 
Pose internally, 1 to 3 grains. 



MATERIA MEDICA. 



811 



Phenyl Salicylate. Used in typhoid 
fever, fermentative dyspepsia, rheumatism. 
Dose, 5 to 15 grains. 

Phosphorus. Used as a nerve stimulant 
in loss of vigor and mental powers, in soft- 
ening of the brain, neuralgia, melancholia, 
chronic eczema, and other affections of the 
skin. Dose, 1-1 00th to l-80th of a grain. 

Physostigma or Calabar Bean. The ripe 
seeds of Physostigma vcnenosum, found in 
West Africa, India, and Brazil. Used in 
lockjaw, strychnine poisoning, constipation, 
loss of tone of the bowels, and chronic 
bronchitis. Dose, 3 grains. 

Physostigmine Salicylate. Has the 
medicinal properties of Physostigma. Given 
as subcutaneous injections to horses in 
colic. Dose, l-80th to l-30th of a grain. 

Physostigmine Sulphate. Uses and dose 
the same as of the salicylate. 

Phytolacca or Poke Root. The dried 
root of Phytolacca decandra, found in all 
parts of the United States. Used as an 
emetic, purgative, and narcotic. Does not 
act as an emetic until from one to two 
hours after taking, and is very severe in its 
effects. Used in chronic rheumatism, gran- 
ular conjunctivitis, cancer, and, as an oint- 
ment in skin diseases. Dose as an altera- 
tive, 1 to 5 grains; as an emetic, 10 to 30 
grains. 

Pilocarpine Hydrochloride. The hydro- 
chloride of an alkaloid obtained from Pilo- 
carpus, to which it is superior on account 
of its less disagreeable taste and in the 
greater certainty of its diaphoretic effect. 
Capsules or gelatine lozenges containing the 
hydrochloride allowed to dissolve slowly in 
the mouth are recommended for the dry- 
ness of mouth and throat caused by phthisis. 
Dose, % to z /i of a grain. 

Pilocarpine Nitrate. Medicinal proper- 
ties and dose the same as of Pilocarpine 
Hydrochloride. 

Pilocarpus or Jaborandi. The leaflets of 
Pilocarpus jaborandi, occurring in South 
America. A diaphoretic much used in 
dropsy, uraemia, rheumatism, coryza, influ- 
enza, Bright's disease. Dose, 20 to 60 
grains. 

Pills or Pilulae. Globular masses of a 
size small enough to be swallowed. This is 
the most convenient method of administer- 
ing medicines of disagreeable taste which 
may be given in small doses. There are 
some medicinal substances which may be 
made into pills of themselves, but the 
greater number require some other sub- 
stances to give them the proper consistency, 



and such substances are called excipients. 
Pills are coated with substances usually in 
powder form to prevent them from mass- 
ing together, such as licorice powder, lyco- 
podium powder, rice flour or starch. Occa- 
sionally pills of particularly disagreeable in- 
gredients are sugar-coated. Compressed tab- 
lets are used to an enormous extent, and 
are displacing not only pills but also many 
compounds of medicine formerly given in 
liquid form. 

Pills of Aloes (Pilulae Aloes). Consist 
of Aloes (of which each pill contains 2 
grains); Soap, used as an excipient ; and 
Water. An excellent laxative in habitual 
costiveness. Dose, 1, 2, or 3 pills at bed- 
time. 

Pills of Aloes and Mastic or Lady 
Webster Pills (Pilulae Aloes et Mas- 
tiches). Consist of Aloes, 2 grains to each 
pill; Mastic, 0.31 grains to a pill; Red 
Rose ; and Diluted Alcohol. The mastic 
probably renders the pill less soluble and 
delays its full effect until it reaches the 
lower bowel. Dose as a laxative, one pill at 
bedtime or before a meal. 

Pills of Asafoetida (Pilulae Asafoe- 
tidae). Consist of Asafoetida, 3 grains to a 
pill ; Soap and Water. Disguises the offen- 
sive taste and odor of asafoetida. Dose, 1 
to 3 pills. 

Compound Cathartic Pills or Anti- 
bilious Pills (Pilulae Catharticae Composi- 
tae). Consists of Compound Extract of 
Colocynth, Mild Mercurous Chloride, Resin 
of Jalap, Gamboge, and Alcohol. Each pill 
weighs 3 grains, of which 2.70 grains are 
of active ingredients. One pill is a mild 
laxative ; a full dose acts vigorously, gen- 
erally without discomfort. Used in bilious 
fevers, hepatitis, and jaundice. Dose, 1 to 
3 pills. 

Vegetable Cathartic Pills (Pilulae 
Catharticae Vegetables). This is a cathar- 
tic pill without mercury. The effect is the 
same as the Compound Cathartic. Dose, 1 
to 3 pills. 

Pills of Ferrous Carbonate or Blaud's 
Pills (Pilulae Ferri Carbonatis). Contain 
Ferrous Carbonate and Potassium Sulphate 
as a result of double decomposition. Dose, 
2 to 6 pills, taken three times a day. 

Pills of Ferrous Iodide (Pilulae Ferri 
Iodidi). Each pill contains about 1 grain 
of Ferrous Iodide and 2-5 of a grain of 
Reduced Iron. Dose, 1 to 3 pills. 

Compound Laxative Pills (Pilulae Laxa- 
tivae Compositae). Contains 1-5 grain of 
Aloin, l-130th grain of Strychnine, % grain 



8l2 



MATERIA MEDICA. 



of Extract of Belladonna Leaves, 1-16 grain 
of Ipecac, and Yi grain of Powdered Lico- 
rice Root. Known also as Pill Lapatic, 
A. B. S. Pills, and Evacuant Pills. Dose 
as a laxative, 1 or 2 pills at night. 

Pills of Opium (Pilulae Opii). Each 
pill contains 1 grain of Powdered Opium 
with soap as an excipient. Dose, 1 pill. 

Pills of Phosphorus (Pilulae Phos- 
phori). Each pill contains about l-100th 
grain of phosphorus in the free state. Dose, 

1 pill. 

Pills of Podophyllum, Belladonna, and 
Capsicum (Pilulae Podophylli, Belladonnae, 
et Capsici). Each pill contains %. grain of 
Resin of Podophyllum, Ys grain of Extract 
of Belladonna Leaves, y 2 grain of Pow- 
dered Capsicum. An excellent form by 
which to secure the laxative effect of podo- 
phyllum. Dose, 1 or 2 pills. 

Compound Pills of Rhubarb (Pilulae 
Rhei Compositae). Each pill contains 2 
grains of Powdered Rhubarb, about 24 of a 
grain of Aloes. An excellent warm tonic 
laxative, useful in costiveness. Dose, 2 to 
4 pills. 

Pimenta or Allspice. The dried ripe 

fruit of Pimenta officinalis, found in the 
West Indies, Mexico, and South America. 
An aromatic spice added to tonics and purg- 
atives. Sometimes used in cases of flatu- 
lence. Dose, 10 to 40 grains. 

Piper or Black Pepper. The dried un- 
ripe fruit of Piper nigrum, found in the East 
Indies. A warm carminative stimulant. 
Dose, 5 to 20 grains. 

Piperine (Piperina). A weak basic sub- 
stance obtained from the Pepper and other 
plants. Its uses are the same as those of 
Pepper. Dose, 3 to 5 grains. 

Pix Liouida or Tar. Obtained by the 
destructive distillation of the wood oiPinus 
palusiris of the South Atlantic states. Used 
in chronic catarrhal affections, diseases of 
the urinary passages ; its vapor inhaled is 
helpful in bronchitis and phthisis ; and is a 
useful application in some skin diseases. 
Dose, 5 to 20 grains. 

Podophyllum, May-Apple or Mandrake 
Root. The dried rhizome of Podophyllum 
peltatum. A slow but active and certain 
cathartic used in bilious fevers and in dis- 
eases of the liver. The powdered root is 
not given, the resin, podophyllum, being 
preferred. Dose of the resin, Yd, to Ya 
grain ; as a purgative, Y to Yz grain. 

POTASSII ACETAS OR POTASSIUM ACETATE, 

A diuretic in doses of from 20 grains to 1 
drachm ; a mild cathartic in doses of from 



3 to 4 drachms. Used in dropsy, skin dis- 
eases, and in rheumatism. Dose, y 2 drachm 
to y 2 ounce. 

POTASSII BlCARBONAS OR POTASSIUM BI- 
CARBONATE. Similar in medicinal effects to 
the carbonate ; its taste, however, is milder, 
and the salt is easily borne by the stomach. 
Dose, 10 grains to 1 drachm. 

POTASSII BlTARTRAS, POTASSIUM BlTAR- 

trate or Cream of Tartar. A very mild, 
saline cathartic; an active, soothing hydra- 
gogue diuretic. Much used in dropsy, and 
often given with senna, sulphur, or jalap. 
Also a refrigerant drink in fevers. Dose, 
as an aperient, 1 to 2 drachms ; as a cathar- 
tic, y 2 to 1 ounce. 

POTASSII BROMIDUM OR POTASSIUM BrO- 

mide. Valuable as a nerve sedative in epi- 
lepsy, convulsions, hysteria, tetanus, delir- 
ium tremens, and in general nervous excite- 
ment. Dose, 10 to 20 grains. 

POTASSII CARBONAS OR POTASSIUM CARBON- 
ATE. Used as an antacid in dyspepsia, a 
diuretic in dropsy, an antilithic in uric acid 
gravel ; and as lotion, bath, or ointment in 
cutaneous affections. In the bath, from Y> 
to 1 pound may be dissolved; lotions, 2 or 
3 drachms in a pint of water ; and oint- 
ments, from 10 grains to 1 drachm in an 
ounce of lard. Dose internally, 10 to 30 
grains. 

POTASSII CHLORAS OR POTASSIUM CHLO- 
RATE. Used in follicular and gangrenous 
stomatitis, scarlatina, diphtheria, pharyn- 
gitis, chronic cystitis, and other inflamma- 
tion of the mucous membrane; as an injec- 
tion with laudanum in hemorrhoids it is 
especially effective. Dose, 5 to 15 grains. 

POTASSII ClTRAS OR POTASSIUM ClTRATE. 

A refrigerant diaphoretic in fevers ; dis- 
solved in lemon juice it is effective in rheu- 
matism and gout ; also valuable in the first 
stage of acute bronchitis. Dose, 20 to 25 
grains. The Effervescent Potassium Citrate 
is an agreeable form of administering potas- 
sium citrate, and may be given in. doses of 
from 1 to 2 teaspoonfuls in cold water. 

POTASSII CYANIDUM OR POTASSIUM CYA- 
NIDE. Acts like hydrocyanic acid (prussic 
acid) both as a poison and as a medicine. 
Dose, Y§ of a grain. 

potassii et sodii tartras, potassium 
and Sodium Tartrate or Rochelle Salts. 
A mild, cooling purgative, easily borne by 
the sensitive and irritated stomach. It is 
one of the ingredients of Seidlitz Powders. 
Dose as a purge, from y 2 to 1 ounce. 

Potassii Hyroxidum or Caustic Potash. 
Used in the form of sticks or in solution as 



MATERIA MEDICA. 



813 



a powerful escharotic. It extends its action 
much more deeply than does lunar caustic 
or silver nitrate, and is more frequently 
used in opening and enlarging abscesses. 

Potassii Hypophosphis or Potassium 
Hypophosphite. Used in phthisis, loss of 
nerve power, debility of the brain, and scrof- 
ulous affections of children. Dose, 10 to 30 
grains. 

Potassii Iodidum or Potassium Iodide. 
Used in rheumatism, for softening inflam- 
matory deposits, removal of exudations, and 
chronic pleurisies. Dose, 5 to 20 grains. 

Potassii Nitras, Potassium Nitrate or 
Nitre. Used occasionally as a local remedy 
for stomatitis, angina, and for inhaling in 
asthma. When given internally it has proved 
very irritating to the gastro-intestinal canal. 

Potassii Permanganas or Potassium 
Permanganate. Used in the treatment of 
fetid ulcers, abscesses, carbuncles, and 
wounds with fetid discharges ; a stimulant 
application in chronic and indolent ulcers. 
Used internally in atonic amenorrhoea. 
Dose, 1 to 2 grains. 

Potassii Sulphas or Potassium Sul- 
phate. A mild purgative. In doses of 
from 20 grains to J4 a drachm it is aperient ; 
in doses of from 4 to 5 drachms it is a 
purgative ; in large doses, it is a poison. 
Dose, 20 grains to 4 drachms. 

Prunum or Prune. The partly dried 
ripe fruit of the Primus domestica. Laxa- 
tive and nutritive, prunes form an excel- 
lent diet in costiveness. In too large quan- 
tities they cause flatulence, griping, and in- 
digestion. 

Prunus Virginiana or Wild Cherry. 
The bark of Prunus serotina, gathered in 
the autumn. Possesses tonic properties, 
calms irritation, and diminishes nervous ex- 
citability. Much used in the hectic fever of 
scrofula and consumption. Dose, 30 to 60 
grains. 

Pulveres or Powders. A convenient 
form for administering medicines of small 
dose, agreeable taste, of no corrosive prop- 
erty, and not liable to deliquesce. When 
composed of only one substance, the powder 
is simple ; when of more than one, com- 
pound. It is customary to sift the powder 
after the substance has been pulverized in 
a mortar. 

PULVIS ACETANILIDI COMPOSITUS OR COM- 
POUND Acetanilid Powder. Acetanilid, 
70 parts ; Sodium Bicarbonate, 20 parts. 
The essential composition of most of the 
proprietary headache powders used in the 
treatment of migraine and neuralgia. Dose, 
5 to 10 grains. 



Pulvis Aromaticus or Aromatic Pow- 
der. Saigon Cinnamon, 35 parts; Ginger, 
35 parts; Cardamom, 15 parts; Nutmeg, 15 
parts. Stimulant and carminative in cases 
of weak digestion with flatulence. Also used 
as a spice plaster and applied over the 
stomach in cases of nausea and vomiting. 
Dose, 10 to 30 grains. 

Pulvis Cretae Compositus or Compound 
Chalk Powder. Prepared Chalk, 30 parts; 
Acacia, 20 parts ; Sugar, 50 parts. Used for 
making Mistura Cretae or Chalk Mixture. 
Dose, J / 2 to 2 drachms. 

Pulvis Effervescens Compositus, Com- 
pound Effervescing Powder or Seidlitz 
Powder. Sodium Bicarbonate, 31 grammes; 
Potassium and Sodium Tartrate, 93 grammes. 
Mix and divide into 12 powders. Then 
take Tartaric Acid, 27 grammes, and divide 
into 12 powders. Dose, 1 set of powders. 

Pulvis Glycyrrhizae Compositus, Com- 
pound Powder of Glycyrrhiza or Com- 
pound Licorice Powder. Senna, 18 parts; 
Glycyrrhiza, 23.6 parts ; Washed Sulphur, 
8 parts ; Oil of Fennel, 0.4 parts ; Sugar, 
50 parts. An agreeable laxative. Dose, 30 
grains. 

Pulvis Ipecacuanhae et Opii, Powder 
of Ipecac and Opium or Dover's Powder. 
Ipecac, 10 parts; Powdered Opium, 10 parts; 
Sugar of Milk, 80 parts. An excellent ano- 
dyne diaphoretic, when there is not much 
fever, brain disturbance, or sick stomach. 
Used in rheumatism, pneumonia, dysentery, 
diarrhoea. There is 1 grain of opium in 10 
grains of the powder. Dose, 5 to 15 grains 
repeated in 4, 6, or 8 hours. Its sweating 
effects may be increased by warm drinks of 
lemonade or herb tea. 

Pulvis Jalapae Compositus or Com- 
pound Powder of Jalap. Jalap, 30 parts; 
Potassium Bitartrate, 65 parts. A good 
cathartic in dropsy and scrofulous diseases 
of glands or joints. Dose, 30 grains to 1 
drachm. 

Pulvis Morphinae Compositus, Com- 
pound Powder of Morphine or Tully's 
Powder. Morphine Sulphate, 1 y 2 parts ; 
Camphor, 32 parts ; Glycyrrhiza, 33 parts ; 
Precipitated Calcium Carbonate, 33 % parts; 
Alcohol, to make 100 parts. A substitute 
for Dover's Powder. One grain of the 
powder contains 1-67 of a grain of morphine 
sulphate. Dose, 10 grains containing about 
1-6 of a grain of morphine sulphate. 

Pulvis Rhei Compositus, Compound 
Powder of Rhubarb or Gregory's Powder. 
Rhubarb, 25 parts ; Magnesium Oxide, 65 
parts; Ginger, 10 parts. A good laxative 
antacid for bowel troubles of children. 



814 



MATERIA MEDICA. 



Dose for an adult, J A to 1 drachm ; for a 
child 2 or 3 years old, 5 to 10 grains. 

Pyrethrum or Pellitory. The root of 
Anachyclus pyretltrum, found on the coasts 
of the Mediterranean. A powerful irritant, 
used as a sialagogue in headache, rheumatic 
and neuralgic pains in the face, toothache, 
palsy of face, tongue, or throat ; and in re- 
laxation of the uvula. A piece of the root 
may be chewed, or the mouth and throat 
may be gargled. Dose. 20 grains. 

Pyrogallol or Pyrogallic Acid. A tri- 
atomic phenol obtained by heating gallic 
acid. A stimulant antiseptic in lupus, pso- 
riasis, and other skin diseases. Extremely 
dangerous. 

Pyroxylinum, Pyroxylin or Soluble 
Gun Cotton. Prepared by the action of 
nitric and sulphuric acids on cotton. Used 
in the preparation of Collodion. 

Quassia. The wood of Picrasma excelsa, 
Jamaica Quassia, or of Quassia amara, Sur- 
inam Quassia. A tonic, simple bitter, invig- 
orating to the digestive organs ; excellent 
in failure of appetite and in general gastric 
debility. Given in infusion, tincture, ex- 
tract, or fluidextract. Dose of the wood, 
5 to 10 grains. 

Quercus or White Oak. The dried bark 
of Quercus alba. A tonic astringent used 
externally in marasmus, scrofula, intermit- 
tent fevers, chronic diarrhoea, and cholera 
infantum as a bath. An injection in leucor- 
rhcea ; a wash in piles and prolapsus ani ; 
and a gargle in prolapsed uvula. 

Quillaja or Soap Bark. The dried bark 
of Quillaja saponaria, found in Peru and 
Chili. Much used in the arts for washing 
fabrics for which soap would not be suit- 
able. 

Quinina or Quinine. An alkaloid ob- 
tained from the bark of several species of 
Cinchona. Quinine Bisulphate, Quinine 
Hydrobromide, Quinine Hydrochloride, and 
Quinine Salicylate are all official prepara- 
tions given in doses of from 2 to 10 grains. 

Quininae Sulphas or Quinine Sul- 
phate. Tonic, antiperiodic, antipyretic. The 
most efficient drug known in malarial dis- 
eases, in which it acts by poisoning the 
Plasmodium malariae in the blood. It is 
antipyretic in febrile diseases. Dose, 1 to 
10 grains. As a tonic 1 grain may be given 
three times a day. 

Resina or Rosin. The residue left after 
distilling of the volatile oil of turpentine. 
Used in ointments and plasters. 

Resinae or Hesins. Solid, brittle prepa- 
rations derived from substances by exhaust- 



ing with alcohol and then precipitating the 
resin by the addition of water with which 
the alcohol unites. 

Resina Jalapae or Resin of Jalap. Made 
into pills with mucilage or alcohol. Dose, 
2 to 5 grains. 

Resina Podophylli or Resin of Podo- 
phyllum. A powerful cathartic. Dose, */& 
to 54 grain. 

Resina Scammonii or Resin of Scam- 
mony. Dose, 4 to 8 grains. 

Resorcinol. A diatomic phenol known 
chemically as metadihydroxybenzene. It is 
similar in its effects to phenol ; internally 
administered in gastric and intestinal ca- 
tarrh, gastric ulcer, and enteritis. In a 
solution of from 1 to 15 per cent it is used 
in hay fever, nasal catarrh, chronic inflam- 
mation of the ear, and leucorrhcea. Val- 
uable in eczema and the several parasitic 
skin diseases without inflammation. Dose, 
2 to 5 grains. 

Rhamnus Purshiana or Cascara Sa- 
grada. The dried bark of Rhamnus purshi- 
ana, found in California. An excellent laxa- 
tive in habitual constipation ; best adminis- 
tered as tincture or fluidextract. 

Rheum or Rhubarb. The dried rhizome 
of Rheum palmatum, found around the Cas- 
pian Sea and the Volga. The several varie- 
ties in commerce are known as : Chinese 
Rhubarb and European Rhubarb, embracing 
English and French. While it is cathartic 
it is also astringent — a peculiar and appar- 
ently paradoxical combination of opposing 
qualities. Used in dyspepsia with constipa- 
tion, diarrhoea when purging is needed, sec- 
ondary stages of cholera infantum, chronic 
dysentery, and in all cases of enfeebled con- 
dition when mild purging is called for. Dose 
as a purgative, 20 to 30 grains ; as a sto- 
machic and laxative, 5 to 10 grains. 

Rhus Glabra or Sumach. The dried 
fruit of Rhus glabra, found in Canada and 
throughout the United States. Astringent 
and refrigerant, used as a gargle in angina. 

Rosa Gallica or Red Rose. The dried 
petals of Rosa gallica collected in the bud. 
Slightly astringent and tonic. Used as an 
agreeable vehicle for tonic and astringent 
medicines. 

Rubus or Blackberry. The dried bark 
of the rhizome of Rubus villosus, and other 
species. Favorite domestic remedy for diar- 
rhoeas. The decoction is made by boiling 
one ounce of small roots, or of the bark of 
the large roots, in a pint and a half of water 
down to one pint. Of this decoction from 



MATERIA MEDICA. 



8iS 



1 to 2 fluidounces may be given to an adult 
3 or 4 times a day or oftener. 

Sabina or Savine. The tops of Jimiperus 
sabina, found in the south of Europe, the 
Levant, and found wild near the great lakes 
of the United States. It is highly irritant, 
and used in amenorrhoea and atonic menor- 
rhagia. Dose, 5 to 10 grains. 

Saccharum or Cane Sugar. The refined 
sugar obtained from Saccharum oMcinarum 
and from several species of Sorghum. Apart 
from its food value, sugar is of use in the 
manufacture of several mixtures, pills, pow- 
ders, confections, syrups, and all troches. 

Saccharum Lactis or Sugar of Milk. 

Safrolum or Safrol. The synthetic oil 
of sassafras. In all its physiological and 
therapeutical effects safrol is the same as 
oil of sassafras. Dose, 5 to 10 minims. 

Salicinum or Salicin. Obtained from 
several species of Salix (Willow) and 
Populus (Poplar). For some time salicin 
was employed in rheumatism, but has been 
largely supplanted by salicylic acid. Dose, 
10 to 30 grains. 

Salvia or Sage. The dried leaves of 
Salvia officinalis. Tonic, astringent, and 
aromatic. Dose, 20 to 60 grains. 

Sanguinaria or Bloodroot. The dried 
rhizome of Sanguinaria canadensis. An 
emetic and stimulant narcotic ; used as a 
stimulant expectorant in advanced stages of 
bronchitis. Dose, 2 grains according to the 
U. S. P. 

Santalum Rubrum or Red Saunders. The 
heart-wood of Pterocarpus santalinus, found 
in India and Ceylon. Used as a coloring 
agent. 

Santonica or Levant Wormseed. The 
dried unexpanded flower heads of Artemisia 
pauciUora, found in Europe and northern 
Asia. Its active principle is santonin. 

Santonin. Obtained from santonica. It 
is a stimulant to the optic nerve in amauro- 
sis ; but is best known as a vermicide. 
Mixed with sugar and tragacanth, santonin 
is made into lozenges that are palatable and 
effective as a vermifuge. Dose for an adult, 

2 to 4 grains ; for a child 2 or 3 years old, 
Vx to y 2 a grain. 

Sapo or White Castile Soap. Made 
from sodium hydroxide and olive oil. Used 
with water to form an enema in cases of 
constipation resulting from impacted or 
hardened faeces. This enema is generally 
made by dissolving two tablespoonfuls of 
soft soap in a pint of warm water. Soap 
is used in pharmacy as an excipient in mak- 



ing pills, and as an ingredient of liniments 
and plasters. Dose, 5 grains to l / 2 drachm. 

Sapo Mollis or Soft Soap. Soap made 
from potassium hydroxide and olive oil or 
from linseed oil, potassium hydroxide, alco- 
hol, and water. Green soap or German 
soap has long been made in Europe from 
linseed or other vegetable oil, potassium 
hydroxide, and a little sodium hydrate. 
The green color is probably due to some 
chlorophyll or green coloring vegetable 
matter in the oils. It is the savon vert of 
France. This green soap differs in no way 
from the soft soap here mentioned. It is 
used as an application in skin diseases, but 
especially in eczema rubrum. It owes its 
efficacy probably to the excess of potassium 
hydroxide (caustic potash). 

Sarsaparilla. The dried root of .Smilax 
medica, grown in Asia, South America, and 
Central America. Used in syphilis, scrofu- 
lous diseases, and cutaneous affections, and 
generally classed as an alterative. Dose, 30 
to 60 grains. 

Sassafras. The dried bark of the root 
of Sassafras variifolium. 

Sassafras Medullae or Sassafras Pith. 
The dried pith of Sassafras variifolium, 
common in the United States and Mexico. 
From its abundant gummy matter is made a 
mucilage of great service in inflammation 
of the eyes ; and a demulcent drink in dys- 
entery, catarrh, and nephritis. It is made 
by adding a drachm of the pith to a pint of 
boiling water. Dose of the bark, 1 to 2 
drachms. 

Scammonium or Scammony. A gum-resin 
exuding from the root of Convolvulus scam- 
monia, exported from Smyrna. An active 
cathartic, often causing discomfort. Dose, 
5 to 10 grains. 

Scilla or Squill. The bulb of Urginea 
maritima, grown on the coasts of the Med- 
iterranean. Expectorant, diuretic, emetic, 
and purgative ; used in dropsy and croup. 
Dose 1 to 2 grains ; in large doses, emetic. 

Scoparius or Broom. The dried tops of 
Cytisus scoparius, grown in Europe. Diu- 
retic, cathartic, and emetic ; used in dropsy. 
Dose, 10 to 15 grains. 

Scopola. The dried rhizome of Scopola 
carniolica, found in Central Europe. Very 
similar in its medicinal properties to bella- 
donna. Used in the manufacture of bella- 
donna plasters and as a source of hyoscya- 
mine. Dose, 1 to 2 grains. 

Scutellaria or Skullcap. The entire 
plant of Scutellaria lateriflora, common 
throughout Canada and the United States. 



8i6 



MATERIA MEDICA. 



Has enjoyed a high reputation as a remedy 
in hydrophobia, neuralgia, and cases of 
nervous excitement. Dose, 30 to 90 grains. 
Senega or Senega Snakeroot. The dried 
root of Polygala senega, common in Canada 
and the United States. A stimulant expec- 
torant used in bronchitis, asthma, and other 
inflammatory pulmonic affections. Dose, 15 
to 20 grains. 

Senna. The dried leaflets of Cassia 
acutifolia or Cassia angustifolia, found in 
India and Egypt. The varieties of com- 
merce are Alexandria Senna, Tripoli Senna, 
India Senna, and Mecca Senna. A prompt, 
efficient, and safe purgative ; of service in 
fevers. Its griping effects are overcome by 
the use of an aromatic or an alkaline salt 
such as Epsom Salt. Dose, y 2 to 2 drachms. 

Serpentaria or Virginia Snakeroot. 
The dried rhizome and roots of Aristolochia 
serpentaria, found everywhere. A feeble 
stimulant tonic of use in intermittent fevers 
and in dyspepsia. Dose, 15 to 30 grains. 

Serum Antidiphthericum or Diphthe- 
ria Antitoxin. A fluid separated from the 
coagulated blood of a horse rendered im- 
mune by inoculation of diphtheric toxin. 
Discovered independently by Behring and 
Roux in 1894. Diphtheria antitoxin is made 
by injecting diphtheria poison into horses, 
usually by subcutaneous (under the skin) 
injection. The horse is chosen because it 
supplies a large quantity of blood and be- 
cause this animal is very sensitive to diph- 
theria poison. The first injection of diph- 
theria poison is small — only 1-10 of a cubic 
centimeter. Swelling occurs at the point of 
inoculation attended by fever and loss of 
appetite. In a few days these symptoms 
disappear. A larger dose is then injected, 
until at the end of a few months the horse 
can stand a dose of from 500 to 1,000 cubic 
centimeters of the poison with less discom- 
fort than attended the extremely small first 
dose. All the while the amount of anti- 
toxin has been steadily accumulating in 
the horse's blood. The horse is bled from 
the external jugular vein. The blood, col- 
lected in long flasks or tubes, is allowed to 
clot. The clear serum collects and is drawn 
off by means of a pipette. This clear serum 
is the Diphtheria Antitoxin. It is a true 
specific for diphtheria, provided that it is 
given in a sufficiently large quantity and 
early enough. As soon as the disease is 
suspected the antitoxin should be adminis- 
tered, for statistics prove that every hour 
of delay lessens the chance of successfully 
coping with the disease. The curative dose 
is from 2,000 to 5,000 units, repeated every 
4 or 8 hours until favorable results are per- 
ceptible. The antitoxin is administered by 



a hypodermic syringe under the skin in any 
part of the body where the skin is loose. 
Near the angle of the shoulder blade is a 
favored spot; though the flank or abdomen 
are often chosen. When administered by 
the mouth the effects are slow, uncertain, 
and unsatisfactory. Its effects are harm- 
less, and not only the suspected patient but 
also those exposed to the infection should 
be treated. 

Sevum Preparatum or Prepared Suet. 
The internal fat of the abdomen of the 
sheep, melted and strained. It is used in 
the preparation of cerates and ointments. 

Sinapis Alba or White Mustard. The 
dried ripe seeds of Sinapis alba. 

Sinapis Nigra or Black Mustard. The 
seed of Brassica nigra. Mustard seeds are 
swallowed whole as a laxative, and as a 
cure for dyspepsia in doses of one table- 
spoonful once or twice a day. The seeds 
may be moistened with molasses or im- 
mersed in hot water. Mustard powder is 
an efficient emetic in quantities of 1 or 2 
teaspoonfuls. The greatest value of mustard 
lies in its power as a rubefacient, best ap- 
plied in the form of a cataplasm. Dose, 1 
or 2 drachms. 

Sodii Acetas or Sodium Acetate. Diu- 
retic but rarely used. Its chief value is as 
a source of acetic acid by the action of 
sulphuric acid. Dose, 20 grains to 2 drachms. 

Sodii Arsenas or Sodium Arsenate. 
Used as other compounds of arsenic in 
chorea and other nervous diseases and in 
rheumatic gout. Dose, 1-10 of a grain. 

Sodii Benzoas or Sodium Benzoate. A 
remedy for gout, rheumatism, lithsemia, and 
tuberculosis. Dose, 20 to 30 grains. 

Sodii Bicarbonas or Sodium Bicarbon- 
ate. Common baking soda or saleratus. Of 
mild taste and slight irritating properties ; 
the bicarbonate is often used instead of the 
carbonate in calculi with excess of uric acid, 
infantile croup, and pneumonia. Dose for 
an adult, 10 grains to 1 drachm. 

Sodii Bisulphis or Sodium Bisulphite. 
Used as all sulphites (see Sodii Sulphis). 
Dose, 5 to 15 grains. 

Sodii Boras, Sodium Borate or Borax. 
Uses and effects are the same as those of 
boric acid. Used in gout, epilepsy ; as a 
powder or solution in external treatment of 
wounds, ulcers, and abscesses. Of great 
value in inflammations of the mouth, of 
mucous membranes generally, and in con- 
junctivitis. Dose, 10 to 20 grains. 

Sodii Bromidum or Sodium Bromide. 
Similar to the effects of potassium bromide, 



MATERIA MEDICA. 



817 



except that sodium bromide is not so high 
a depressant of the circulation. Dose, 15 
grains to 1 drachm. 

Sodii Chloras or Sodium Chlorate. 
Effects the same as those of potassium 
chlorate, but it is much more soluble. Dose, 
5 to 15 grains. 

Sodii Chloridum, Sodium Chloride or 
Common Salt. In small doses, a stomachic 
tonic and anthelmintic ; in larger doses, a 
purgative and emetic. In haemoptysis a tea- 
spoonful of common salt, taken dry, will 
sometimes check the flow of blood. It is 
a valuable external fomentation in sprains, 
bruises, and as a bath for depraved condi- 
tions often existing in a child. Dose as a 
cathartic, 2 drachms to half an ounce ; as 
an emetic, y 2 ounce to 1 ounce ; as a clyster, 
2 tablespoonfuls to be dissolved in a pail of 
water. 

Sodii Citras or Sodium Citrate. Used 
for the same purposes as potassium citrate. 
Dose, 15 to 60 grains. 

Sodii Hydroxidum or Caustic Soda. 
Used in gall-stones, acidity of the stomach 
or intestines, and externally in skin diseases. 

Sodii Hypophosphis or Sodium Hypo- 
phosphite. Used in phthisis, loss of nerve 
power, scrofula, and defects of bone tissues. 
Dose, 10 to 20 grains. 

Sodii Iodidum or Sodium Iodide. Of the 
same value as potassium iodide. Dose, 10 
grains. 

Sodii Nitras or Sodium Nitrate. An 
important remedy in dysentery, but rarely 
used. Dose, ^ to 1 ounce. 

Sodii Nitris or Sodium Nitrite. Effects 
are similar to those of amyl nitrite or nitro- 
glycerine. Commencing dose, never to ex- 
ceed 3 grains. 

Sodii Phosphas or Sodium Phosphate. 
A mild purgative acting very favorably with 
small children and with adults of delicate 
stomach. Restores healthy color of stool 
in cases of children suffering from deficient 
or disordered bile as indicated by white or 
green stools with diarrhoea. Dose, 3 to 10 
grains. Small doses according to age may 
be given to children in milk. 

Sodii Salicylas or Sodium Salicylate. 
Effects are the same as those of salicylic 
acid, except that sodium salicylate is more 
soluble and less irritating. Dose, 10 to 30 
grains. 

Sodii Sulphas, Sodium Sulphate or 
Glauber's Salts. An effective hydragogue 
cathartic ; in small doses, a diuretic and 
aperient. Dose, 2 drachms to 1 ounce. 



Sodii Sulphis or Sodium Sulphite. 
Used in yeasty vomiting ; as an outward 
application to aphthous sore mouth. Dose, 
15 to 60 grains; as a wash, a drachm of the 
salt in an ounce of water. 

Sodii Thiosulphas or Sodium Thiosul- 
phate. A powerful poison to fungi in 
pyaemia, zymotic disorders, parasitic affec- 
tions of the mouth and skin. Dose, 10 to 20 
grains ; as a wash, a drachm dissolved in 
an ounce of water. 

Sparteinae Sulphas or Sparteine Sul- 
phate. An alkaloid possessing the same 
effects as those of scoparius, from which it 
is derived. Dose, 1-6 to y 2 grain. 

Spigelia or Pinkroot. The dried rhi- 
zome and roots of Spigelia marilandica or 
Carolina pink. A powerful anthelmintic. 
A worm tea consists of spigelia, senna, 
manna, and savine. Dose of the powdered 
root, for a child 3 or 4 years old, 10 to 20 
grains ; for an adult, 1 to 2 drachms. Give 
the proper dose night and morning for sev- 
eral successive days and follow with a brisk 
cathartic. 

Spiritus or Spirits. Alcoholic solutions 
of volatile substances formerly obtained by 
distillation, but now usually made by dis- 
solving the volatile substance in alcohol. 

Spiritus Aetheris or Spirit of Ether. 
Ether, 32^2 parts; Alcohol,. 67 y 2 parts. 
Dose, 1 to 3 fluidrachms, 

Spiritus Aetheris Compositus, Com- 
pound Spirit of Ether or Hoffman's 
Anodyne. Ether, 32^ parts; Alcohol, 65 
parts; Ethereal Oil, 2y 2 parts. Very useful 
in nervous irritation and consequent loss of 
sleep. Dose, 30 minims to 2 fluidrachms. 

Spiritus Aetheris Nitrosi or Sweet 
Spirit of Nitre. An alcoholic solution of 
Ethyl Nitrite — not less than 4 per cent. 
Diaphoretic, diuretic, and antispasmodic. A 
very popular and useful remedy. Dose, x / 2 
to 1 fluidrachm. 

Spiritus Ammoniae Aromaticus. See 
Aromatic Spirit of Ammonia. 

Spiritus Amygdalae Amarae or Spirit 
of Bitter Almond. A 1 per cent solution 
of the oil in alcohol and water. Used as a 
flavoring extract in quantities of only a few 
drops, as it contains hydrocyanic acid. Dose, 
2 to 8 minims. 

Spiritus Anise or Spirit of Anise. A 
10 per cent solution of the Oil of Anise in 
alcohol and water. A stomachic and car- 
minative. Dose, 1 to 2 fluidrachms. 

Spiritus Aurantii Compositus or Com- 
pound Spirit of Orange. A 20 per cent 



8i8 



MATERIA MEDICA. 



solution of the Oil of Orange Peel in alco- 
hol and water. A useful and fragrant addi- 
tion to prescriptions. 

Spiritus Camphorae or Spirit of Cam- 
phor. Camphor, 10 grammes; Alcohol, to 
make 100 cubic centimeters. Used locally 
in liniments, and internally in affections of 
the alimentary canal and as an antispas- 
modic. Dose, 10 to 30 minims. 

Spiritus Chloroformi or Spirit of 
Chloroform. Chloroform, 6 parts ; Alco- 
hol, 94 parts. An internal remedy in gastric 
spasm. Dose, 10 to 60 minims. 

Spiritus Cinnamomi or Spirit of Cin- 
namon. A 10 per cent solution of the Oil 
of Cinnamon in alcohol. An agreeable aro- 
matic cordial. Dose, 5 to 20 minims in 
water. 

Spiritus Frumenti or Whiskey. An 
alcoholic stimulant ; its tendency to cause 
constipation is less than that of brandy. 

Spiritus Gaultheria or Spirit of Win- 
tergreen. A 5 per cent solution of Oil of 
Gaultheria in alcohol. A flavoring agent. 
Dose, 10 to 20 minims. 

Spiritus Glycerylis Nitratis, Spirit of 
Nitroglycerine or Spirit of Glonoin. A 
1 per cent solution of Glyceryl Trinitrate 
in alcohol. Its effect upon the system is 
the same as that of the nitrites. Used in 
angina pectoris, asthma, convulsions ; a 
cardiac stimulant in poisoning by illuminat- 
ing gas or in collapse. Dose, 1 to 2 minims. 

Spiritus Juniperi Compositus, Com- 
pound Spirit of Juniper. Corresponds 
very closely to Holland Gin. Contains Oil 
of Juniper, Oil of Caraway, Oil of Fennel, 
alcohol, and water. Added to diuretic mix- 
tures in dropsy. Dose, 2 to 4 fluidrachms. 

Spiritus Lavandulae or Spirit of Lav- 
ender. A 5 per cent solution of Oil of 
Lavender Flowers in alcohol. A perfume 
and ingredient of other preparations. Dose, 
5 to 10 minims. 

Spiritus Menthae Piperitae or Spirit 
of Peppermint. Popularly known as Es- 
sence of Peppermint. A 10 per cent solu- 
tion of the Oil of Peppermint in alcohol. 
Dose, 10 to 30 minims. 

Spiritus Menthae Viridis or Spirit of 
Spearmint. A 10 per cent solution of Oil 
of Spearmint in alcohol. Like peppermint 
it is a carminative. Dose, 10 to 30 minims. 

Spiritus Vini Gallici or Brandy. A 
cordial and stomachic ; often given in the 
sinking stages of low fevers. 

Staphisagria or Stavesacre. The ripe 
seed of Delphinium staphisagria of southern 



Europe. An emetic and cathartic, seldom 
used internally because of its violence. 
A tincture has been used as a liniment in 
rheumatism ; an ointment destroys lice and 
the itch insect. 

Stillingia or Queen's Root. The dried 
root of Stillingia sylvatica, found from Vir- 
ginia to Florida. In large doses an emetic 
and cathartic ; in smaller doses, an altera- 
tive in syphilis, scrofula, cutaneous diseases, 
and chronic liver troubles. Best adminis- 
tered as fluidextract. 

Stramonium. The dried leaves of Datura 
stramonium. Very similar in its effects to 
belladonna. Used in asthma, the dried 
leaves being smoked as tobacco. Dose, 1 to 
5 grains of the leaves. 

Strontii Bromidum or Strontium Bro- 
mide. Used in epilepsy in place of potas- 
sium bromide, as it deranges nutrition less 
and is less irritating. Dose, 15 to 30 grains. 

Strontii Iodidum or Strontium Iodide. 
Supplies the alterative influence of iodine 
without the irritating effect. Dose, 5 to 15 
grains. 

Strontii Salicylas or Strontium Sali- 
cylate. Of especial value in rheumatism, 
as it has slight disturbing effect upon diges- 
tion. Dose, 5 to 30 grains. 

Strophanthus. The ripe seed of Stro- 
phantus kombe, found in Africa and Asia. 
It is known as arrow-poison in Africa. Its 
use in medicine is much the same as that 
of digitalis ; but it requires extreme caution 
on account of its highly poisonous proper- 
ties. Dose, J / 2 to 2 grains. 

Strychnina or Strychnine. An alka- 
loid derived from Nux Vomica. While 
highly poisonous, it is a very valuable tonic, 
usually given with iron and quinine or other 
simple bitter in anaemia ; also in palsies, 
bronchitis, anaesthesia, shock, narcotic poi- 
soning, and a stimulant in low diseases. 
Dose, 1-30 to 1-60 of a grain. Strychnine 
Nitrate and Strychnine Sulphate are also 
official. 

Styrax. A balsam obtained from the 
Liquidambar orientalis, found in Asia Minor. 
A stimulant expectorant and feeble germi- 
cide ; important now as an ingredient of the 
Compound Tincture of Benzoin. Dose, 10 
to 20 grains. 

Sulphonethylmethanum or Sulpho- 
nethylmethane. Called also trional; pro- 
duces quiet, apparently normal, sleep in 
from 15 minutes to 1 hour after taking, 
without unpleasant after-effects. Dose, 10 
to 20 grains. 



MATERIA MEDICA. 



819 



SULPHOMETHANUM OR SuLPHOMETHANE. 

Also called sulphonal ; produces sleep in 
from half an hour to an hour after taking 
without unpleasant after-effects. Dose, 10 
to 40 grains in powder. 

Sulphur Lotum or Washed Sulphur. 
Dose, 1 to 3 drachms. 

Sulphur Precipitatum, Precipitated 
Sulphur or Milk of Sulphur. Similar in 
properties to Sublimed Sulphur. Dose, 1 to 
3 drachms. 

Sulphur Sublimatum or Sublimed Sul- 
phur. Laxative, diaphoretic and resolvent. 
Used in hemorrhoids, gout, rheumatism, 
catarrh, and asthma. Locally it is used in 
scabies or itch ; blown into the throat in 
diphtheria. Dose, 1 to 3 drachms. 

SULPHURIS IODIDUM OR SULPHUR IODIDE. 

Prepared by the direct action of sulphur 
and iodine. Used in the form of ointment 
in skin diseases such as tinea capitis, lupus, 
and lepra. 

Sumbul or Muskroot. The dried rhi- 
zome and root of a plant, probably of the 
Umbelliferae family, found in Asia. A nerv- 
ous stimulant, antispasmodic, used in dysen- 
tery, diarrhoea, amenorrhcea, hysteria, chlo- 
rosis. Dose, y 2 to 2 drachms. 

Suppositoria or Suppositories. Solid 
bodies intended to convey medicinal agents 
into the body, usually by way of the rectum, 
with a view to either evacuating the bowel 
or to apply curative agents to the mucous 
membrane. Cacao butter has been used 
since 1852 and has proved very serviceable, 
as it melts at about the temperature of the 
body after it has been inserted. Sometimes 
in warm weather or in hot countries, wax, 
resin, or some less easily melting substance 
is mixed with the cacao butter. 

Suppositoria Glycerini or Suppositories 
of Glycerine. Glycerine, 30 grammes ; Mono- 
hydrated Sodium Carbonate, y 2 gramme ; 
Stearic Acid, 2 grammes ; Water, 5 cubic 
centimeters. To make 10 suppositories. 
Much used in constipation. The long con- 
tinued use of these or of any suppositories 
may be harmful. 

Syrupi or Syrups. Concentrated solu- 
tions of sugar in aqueous fluids, with or 
without medicinal agents. Without medi- 
cines, they are called simple syrups ; with 
medicines, medicated syrups. 

Syrupus, Syrup, or Simple Syrup. Sugar, 
850 grammes; Water, to make 100 cubic 
centimeters. Used in making pills, mix- 
tures, and many other pharmaceutical prep- 
arations. 



Syrupus Acaciae or Syrup of Acacia. 
Acacia, 100 grammes; Sugar, 800 grammes; 
Water, 430 cubic centimeters. Used in the 
preparation of mixtures, pills, troches, and 
as a demulcent to add to prescriptions. 

Syrupus Acidi Citrici or Syrup of Cit- 
ric Acid. Citric Acid, 10 grammes; Water, 
10 cubic centimeters; Tincture of Fresh 
Lemon Peel, 10 cubic centimeters; Syrup, 
to make 1,000 cubic centimeters. An agree- 
able and refrigerant addition to carbonated 
drinks. 

Syrupus Acidi Hydriodici or Syrup of 
Hydriodic Acid. Diluted Hydriodic Acid, 
100 grammes; Water, 300 grammes; Syrup, 
600 grammes. Used to produce alterative 
effects in scrofula. Dose, 1 to 2 fluidrachms. 

Syrupus Amygdalae or Syrup of Al- 
mond. Spirit of Bitter Almond, 10 cubic 
centimeters; Orange Flower Water, 100 
cubic centimeters; Syrup, to make 1,000 
cubic centimeters. Added to cough mix- 
tures, or to conceal the taste of disagree- 
able medicines. Dose, 1 to 2 fluidrachms. 

Syrupus Aurantii or Syrup of Orange. 
Tincture of Sweet Orange Peel, 50 cubic 
centimeters ; Citric Acid, 5 grammes ; Mag- 
nesium Carbonate, 10 grammes; Sugar, 820 
grammes; Water, to make 1,000 cubic centi- 
meters. Used for its agreeable flavor. 

Syrupus Aurantii Florum or Syrup of 
Orange Flowers. Sugar, 850 grammes; 
Orange Flower Water, to make 1,000 cubic 
centimeters. A flavoring agent. Dose, 1 
fluidrachm. 

Syrupus Calcii Lactophosphatis or 
Syrup of Calcium Lactophosphate. Pre- 
cipitated Calcium Carbonate, 25 grammes ; 
Lactic Acid, 60 cubic centimeters ; Phos- 
phoric Acid, 36 cubic centimeters; Orange 
Flower Water, 50 cubic centimeters ; Sugar, 
725 grammes ; Water, to make 1,000 cubic 
centimeters. An excellent mode of admin- 
istering Calcium Phosphate. Dose, 2 to 4 
fluidrachms. 

Syrupus Calcis, Syrup of Lime or 
Syrup of Calcium Hydroxide. Lime, 65 
grammes; Sugar, 350 grammes; Water, to 
make 1,000 cubic centimeters. An active 
antacid and astringent, much used in place 
of limewater. Dose, 10 to 30 minims. 

Syrupus Ferri Iodidi or Syrup of Fer- 
rous Iodide. Iron Wine, 12^2 grammes; 
Iodine, 41 y 2 grammes ; Diluted Hypophos- 
phorous Acid, 20 cubic centimeters ; Sugar, 
600 grammes ; Water, to make 1,000 cubic 
centimeters. A combination of the altera- 
tive effect of iodine with the action of iron ; 
very useful in tuberculosis and scrofula of 



820 



MATERIA MEDICA. 



children. Dose for an adult, 30 to 40 min- 
ims; for a child of two years, 5 to 10 
minims. 

Syrupus Hypophosphitum or Syrup of 
Hypophosphites. Calcium Hypophosphite, 
45 grammes; Potassium Hypophosphite, 15 
grammes; Sodium Hypophosphite, 15 
grammes ; Diluted Hypophosphorous Acid, 
2 grammes; Sugar, 650 grammes; Tincture 
of Fresh Lemon Peel, 5 cubic centimeters ; 
Water, to make 1,000 cubic centimeters. An 
excellent means of administering the hypo- 
phosphites. Dose, 1 to 2 fluidrachms. 

Syrupus Hypophosphitum Compositus 
or Compound Syrup of Hypophosphites. 
Calcium Hypophosphite, 35 grammes; Potas- 
sium Hypophosphite, 17^ grammes ; Sodium 
Hypophosphite, \7 J / 2 grammes; Ferric Hypo- 
phosphite, 2% grammes; Manganese Hypo- 
phosphite, 2 J4 grammes; Quinine, 1.1 
grammes; Strychnine, 115 milligrammes; 
Sodium Citrate, Z% grammes; Diluted Hy- 
pophosphorous Acid, 15 cubic centimeters; 
Sugar, 775 grammes; Water, to make 1,000 
cubic centimeters. An excellent combina- 
tion of the properties of the hypophosphites 
and the effects of iron ; in scrofula. Dose, 
1 to 2 fluidrachms. 

Syrupus Krameriae or Syrup of Kra- 
meria. Fluidextract of Krameria, 450 cubic 
centimeters; Syrup, 550 cubic centimeters. 
Dose, 2 fluidrachms ; for a child a year or 
two old, 10 to 20 minims. 

Syrupus Lactucarii or Syrup of Lac- 
tucarium. Dose, 2 to 3 fluidrachms. 

Syrupus Picis Liquidae or Syrup of 
Tar. Tar, 5 grammes ; Alcohol, 50 cubic 
centimeters; Magnesium Carbonate, 10 
grammes; Sugar, 850 grammes; Water, to 
make 1,000 cubic centimeters. Dose, 1 to 2 
fluidrachms. 

Syrupus Pruni Virginianae or Syrup 
of Wild Cherry. Wild Cherry Bark in 
powder, 150 grammes; Sugar, 700 grammes; 
Glycerine, 150 cubic centimeters; Water, to 
make 1,000 cubic centimeters. Largely used 
as a basis for cough mixtures. Dose, l / 2 
fluidounce. 

Syrupus Rhei or Syrup of Rhubarb. 
Fluidextract of Rhubarb, 100 cubic centi- 
meters ; Spirit of Cinnamon, 4 cubic centi- 
meters ; Potassium Carbonate, 10 grammes; 
Water, 50 cubic centimeters ; Syrup, to make 
1,000 cubic centimeters. Dose, 1 to 2 
fluidrachms. 

Syrupus Rhei Aromaticus or Aromatic 
Syrup of Rhubarb. Aromatic Tincture of 
Rhubarb, 150 cubic centimeters; Potassium 
Carbonate, 1 gramme ; Syrup, 850 cubic cen- 



timeters. A warm stomachic laxative, too 
feeble for adults but well suited for the 
bowel complaints of children in summer. 
Dose for an infant with diarrhoea, 1 flui- 
drachm. 

Syrupus Rosae or Syrup of Rose. Fluid- 
extract of Rose, 125 cubic centimeters ; 
Diluted Sulphuric Acid, 10 cubic centi- 
meters; Sugar, 750 grammes; Water, to 
make 1,000 cubic centimeters. A mild 
astringent ; but chiefly used for its fine red 
color. Dose, 1 fluidrachm. 

Syrupus Rubi or Syrup of Blackberry 
Bark. Fluidextract of Rubus, 250 cubic 
centimeters; Syrup, 750 cubic centimeters. 
Used in acute diarrhoea and in chronic diar- 
rhoea. Dose, 1 to 2 fluidrachms. 

Syrupus Sarsaparillae Compositus or 
Compound Syrup of Sarsaparilla. Fluid- 
extract of Sarsaparilla, 250 cubic centi- 
meters; Fluidextract of Glycyrrhiza, 15 
cubic centimeters ; Fluidextract of Senna, 
15 cubic centimeters; Sugar, 650 grammes; 
Oil of Sassafras, 2-10 of a cubic centimeter; 
Oil of Anise, 2-10 of a cubic centimeter; 
Oil of Gaultheria, 2-10 of a cubic centi- 
meter ; Water, to make 1,000 cubic centi- 
meters. Dose, y 2 fluidounce. 

Syrupus Scillae or Syrup of Squill. 
Vinegar of Squill, 450 cubic centimeters; 
Sugar, 800 grammes; Water, to make 1,000 
cubic centimeters. An expectorant, useful 
in infantile bronchitis. Dose, 1 fluidrachm. 

Syrupus Scillae Compositus or Com- 
pound Syrup of Squill. Fluidextract of 
Squill, 80 cubic centimeters ; Fluidextract of 
Senega, 80 cubic centimeters ; Antimony and 
Potassium Tartrate, 2 grammes ; Purified 
Talc, 20 grammes; Sugar, 750 grammes; 
Water, to make 1,000 cubic centimeters. 
Emetic, diaphoretic, expectorant, and cathar- 
tic. Given in mild cases of croup. Dose, 
for a child, from 10 minims to a fluidrachm, 
according to age ; for adults, as an expecto- 
rant, 20 to 30 minims. 

Syrupus Senegae or Syrup of Senega. 
Fluidextract of Senega, 200 cubic centi- 
meters ; Syrup, 800 cubic centimeters. Used 
in pectoral complaints. Dose, 1 to 2 flui- 
drachms. 

Syrupus Sennae or Syrup of Senna. 
Fluidextract of Senna, 250 cubic centimeters; 
Oil of Coriander, 5 cubic centimeters ; Syrup, 
to make 1,000 cubic centimeters. Dose for 
an adult, 2 to 4 fluidrachms ; for children, 
not more than from ,Ys to J / 2 that quantity. 

Syrupus Tolutanus or Syrup of Tolu. 
Tincture of Tolu, 50 cubic centimeters; 
Magnesium Carbonate, 10 grammes; Sugar, 



MATERIA MEDICA. 



821 



820 grammes; Water, to make 1,000 cubic 
centimeters. Used chiefly for its agreeable 
flavor. 

Syrupus Zingiberis or Syrup of Ginger. 
Fluidextract of Ginger, 30 cubic centimeters ; 
Alcohol, 20 cubic centimeters ; Magnesium 
Carbonate, 10 grammes ; Sugar, 820 grammes ; 
Water, to make 1,000 cubic centimeters. A 
warm stomachic addition to tonics and pur- 
gatives, and a flavoring agent. Dose, 1 
fluidrachm. 

Talcum or Talc. A hydrous magnesium 
silicate. 

Talcum Purificatum or Purified Talc. 
Used as a soothing, protecting powder, and 
forms the basis of most of the proprietary 
toilet powders. 

Tamarindus or Tamarind. The pulp of 
the fruit of Tamarindus indica, found in the 
East Indies, Arabia, Egypt, and the West 
Indies. A laxative and refrigerant ; when 
infused in water it forms an agreeable drink 
in fevers. Dose, 1 drachm to 1 ounce. 

Taraxacum or Dandelion. The dried 
root of Taraxacum officinale. Slightly tonic, 
diuretic, and aperient ; has a specific action 
on the liver. Dose, 1 to 3 drachms. 

Terebenum or Terebene. Obtained by 
the action of concentrated sulphuric acid on 
oil of turpentine. A stimulant expectorant 
in chronic bronchitis, winter cough, acute 
bronchitis. Dose, 3 to 10 minims. 

Terebinthina Canadensis, Canadian Tur- 
pentine, Canadian Balsam or Balsam of 
Fir. An oleoresin from Abies balsamea. 
The properties of the several sorts of tur- 
pentine are those of the oil of turpentine. 
Dose, 20 to 30 grains. 

Terpini Hydras or Terpin Hydrate. 
Acts upon the nervous system like oil of 
turpentine ; used in bronchitis, both chronic 
and acute, and in chronic cystitis. Dose, 
2 to 3 grains. 

Thymol. A phenol derived from the oil 
of Thymus vulgaris; used as a substitute 
for phenol on account of its pleasant odor. 
In the strength of 1 in 1,000 it is used as 
a dressing for unhealthy wounds ; an intes- 
tinal antiseptic in catarrh of the intestines. 
Dose, 2 to 10 grains. 

Thymolis Iodidum or Thymol Iodide. 
An application to ulcerations, eczema, pso- 
riasis, and other skin affections ; and a sub- 
stitute for iodoform. 

Tincturae or Tinctures. Alcoholic solu- 
tions of medicinal agents, prepared by mac- 
eration, digestion, or percolation. Ammo- 
niated tinctures are solutions in ammonia; 



ethereal tinctures are solutions in ethereal 
spirit. 

TlNCTURA ACONITI OR TlNCTURE OF AcO- 

nite. Dose, 3 to 10 minims; but, if to be 
frequently repeated, 2 to 5 minims. 

Tinctura Aloes or Tincture of Aloes. 
Dose as a purgative, 2 to 4 fluidrachms ; as 
a laxative, y 2 to 1 fluidrachm. 

Tinctura Aloes et Myrrhae or Tinc- 
ture of Aloes and Myrrh. Purgative, 
tonic, and emmenagogue ; much used in 
chlorosis and amenorrhoea with constipation. 
Dose, 1 to 2 fluidrachms. 

Tinctura Arnicae or Tincture of Ar- 
nica. A popular application to bruises, 
sprains, tumors, and in local rheumatic pains. 

Tinctura Asafoetidae or Tincture of 
Asafoetida. Dose, 3 minims to 1 fluidrachm. 

Tinctura Aurantii Amari or Tincture 
of Bitter Orange Peel. An agreeable ad- 
dition to infusions, decoctions, and mix- 
tures. Dose, 1 to 2 fluidrachms. 

Tinctura Aurantii Dulcis or Tincture 
of Sweet Orange Peel. A flavoring agent. 

Tinctura Belladonnae Foliorum or 
Tincture of Belladonna Leaves. Dose, 10 
to 30 minims. The dose of the British tinc- 
ture is 5 to IS minims. 

Tinctura Benzoini or Tincture of Ben- 
zoin. Is added to ointments to prevent 
rancidity. Dose, 20 to 30 minims. 

Tinctura Benzoini Composita, Com- 
pound Tincture of Benzoin or Friar's 
Balsam. Contains now only 10 per cent 
of Benzoin instead of 12 as formerly. A 
stimulating expectorant in chronic catarrhs ; 
chiefly as a local application to indolent 
ulcers, chapped nipples. Dose, 15 minims to 
1 drachm. 

Tinctura Calendulae or Tincture of 
Calendula. Used externally like Tincture 
of Arnica. 

Tinctura Calumbae or Tincture of Ca- 
lumba. Dose, 1 fluidrachm. 

Tinctura Cannabis Indicae or Tincture 
of Indian Cannabis. Dose, 15 to 30 minims. 

Tinctura Cantharidis or Tincture of 
Cantharides. Dose, 2 to 5 minims. 

Tinctura Capsici or Tincture of Capsi- 
cum. Dose, 5 to 10 minims. 

Tinctura Cardamomi or Tincture of 
Cardamom. Strength of this tincture is 
double that of the former preparation. 
Dose, y 2 to 1 fluidrachm. 



822 



MATERIA MEDICA. 



Tinctura Cardamomi Composita or Com- 
pound Tincture of Cardamom. Stronger 
than the compound tincture as formerly 
prepared. An aromatic tincture, carmina- 
tive, and imparts an agreeable taste to other 
preparations. Dose, 1 to 2 fluidrachms. 

Tinctura Cimicifugae or Tincture of 
Cimicifuga. Dose, 1 to 2 fluidrachms. 

Tinctura Cinchonae or Tincture of 
Cinchona. Rarely prescribed, but may be 
used as a tonic. Dose, 1 to 2 fluidrachms. 

Tinctura Cinchonae Composita or 
Compound Tincture of Cinchona. An 
excellent stomachic cordial tonic. Dose, 1 
to 2 fluidrachms. 

Tinctura Cinnamomi or Tincture of 
Cinnamon. Now double the strength of the 
former tincture. Dose, 1 to 4 fluidrachms. 

Tinctura Colchici Seminis or Tincture 
of Colchicum Seed. Strength lowered to 
10 per cent in the last revision of the Phar- 
macopoeia to comply with the rule regard- 
ing potent tinctures. Dose, 15 to 30 minims. 

Tinctura Digitalis or Tincture of Digi- 
talis. One third weaker than the former 
tincture. Dose, 10 to 30 minims. 

Tinctura Ferri Chloridi or Tincture 
of Ferric Chloride. One of the most 
active and certain of the iron preparations. 
A standard remedy in erysipelas. To be 
taken through a glass rod to protect the 
teeth. Dose, 5 to 30 minims. 

Tinctura Gallae or Tincture of Nut- 
gall. Powerfully astringent. Dose, 1 to 3 
fluidrachms. 

Tinctura Gambir Composita or Com- 
pound Tincture of Gambir. An agreeable 
astringent tonic designed to replace the old 
Compound Tincture of Catechu, than which 
it is much more advantageous. Dose, 2 to 
4 fluidrachms ; of the British tincture, J /Z> to 
2 fluidrachms. 

Tinctura Gelsemii or Tincture of Gel- 
semium. Dose, 10 to 30 minims. 

Tinctura Gentianae Composita or Com- 
pound Tincture of Gentian. An excellent 
bitter much used in dyspepsia. Dose, 1 to 2 
fluidrachms. 

Tinctura Guaiaci or Tincture of Gua- 
iac. Given in chronic rheumatism and gout. 
Dose, 1 fluidrachm. 

Tinctura Guaiaci Ammoniata or Ammo- 
niated Tincture of Guaiac. Given in 
chronic rheumatism and amenorrhcea. Dose, 
1 to 2 fluidrachms. 

Tinctura Hydrastis or Tincture of 
Hydrastis. Dose, 1 to 2 fluidrachms. 



Tinctura Hyoscyami or Tincture of 
Hyoscyamus. Dose, ^ to 1 fluidrachm. 

Tinctura Iodi or Tincture of Iodine. 
For external use in erysipelas, chilblains, 
and other cutaneous inflammations. Usually 
painted on with a camel's-hair brush. 

Tinctura Ipecacuanhae et Opii or Tinc- 
ture of Ipecac and Opium. Also called 
Fluid Dover's Powder. Dose, 5 to 10 
minims. 

Tinctura Kino or Tincture of Kino. 
Chiefly used as an addition to chalk mix- 
ture in diarrhoea. Dose, 1 to 2 fluidrachms. 

Tinctura Krameriae or Tincture of 
Krameria. Dose, 1 to 2 fluidrachms. 

Tinctura Lactucarii or Tincture of 
Lactucarium. Dose, ^ to 1 fluidrachm. 

Tinctura Lavandulae Composita or 
Compound Tincture of Lavender. An ex- 
cellent preparation for gastric uneasiness, 
nausea, and flatulence. Dose, 30 minims to 
1 fluidrachm. 

Tinctura Limonis Corticis or Tincture 
of Lemon Peel. A grateful aromatic addi- 
tion to tonic infusions. Dose, 1 to 2 flui- 
drachms. 

Tinctura Lobeliae or Tincture of Lo- 
belia. Emetic and narcotic ; much used in 
asthma. Dose, as an expectorant, 15 min- 
ims to 1 fluidrachm ; as an emetic, 1 to 2 
fluidrachms. 

Tinctura Moschi or Tincture of Musk. 
Dose, 30 minims to 2 fluidrachms. 

Tinctura Myrrhae or Tincture of 
Myrrh. A local application to indolent and 
foul ulcers, spongy gums, aphthous sore 
mouth, and ulcerations of the throat. 

Tinctura Nucis Vomicae or Tincture 
of Nux Vomica. Dose, 10 to 20 minims. 

Tinctura Opii, Tincture of Opium or 
Laudanum. Eleven minims or 22 drops of 
the tincture is the equivalent of 1 grain of 
opium. Dose, 5 to 10 minims. 

Tinctura Opii Ammoniata or Ammoni- 
ated Tincture of Opium. Dose, 30 minims 
to 1 fluidrachm. 

Tinctura Opii Camphorata, Camphor- 
ated Tincture of Opium, or Paregoric. A 
pleasant anodyne, used in cough, nausea, 
stomach and bowel pains, diarrhoea, and to 
cause sleep. Dose for an infant, 5 to 20 
minims; for an adult, 1 to 4 fluidrachms. 

Tinctura Opii Deodorata or Deodorized 
Tincture of Opium. Dose, 5 to 10 minims. 

Tinctura Physostigmatis or Tincture 
of Physostigmata. Dose, 20 to 40 minims. 



MATERIA MEDICA. 



823 



TlNCTURA PYRETHRI OR TlNCTURE OF 

Pyrethrum. A powerful local irritant; an 
ingredient of mouth and tooth washes. 

TlNCTURA QUASSIAE OR TlNCTURE OF 

Quassia. Strength doubled in the last re- 
vision. An excellent addition to tonic mix- 
tures. Dose, ^ to 1 fluidrachm. 

TlNCTURA QUILLAJAE OR TlNCTURE OF 

Quillaja. Dose, ^ to 1 fluidrachm. 

TlNCTURA RHEI OR TlNCTURE OF RHU- 
BARB. Doubled in strength of rhubarb and 
cardamom in the last revision. Dose, 1 to 
2 fluidrachms. 

Tinctura Rhei Aromatica or Aromatic 
Tincture of Rhubarb. Dose for an adult, 
y 2 to 1 fluidrachm. 

TlNCTURA SANGUINARIAE OR TlNCTURE OF 

Bloodroot. Emetic in dose of from 3 to 
4 fluidrachms ; expectorant and alterative in 
15 to 60 minim doses. 

TlNCTURA SCILLAE OR TlNCTURE OF SQUILL. 

Dose, as an expectorant or diuretic, 10 to 
20 minims (20 to 40 drops). 

TlNCTURA SERPENTARIAE OR TlNCTURE OF 

Serpentaria. Strength of this tincture was 
doubled in the last revision. Dose, 30 
minims to 2 fluidrachms. 

TlNCTURA STRAMONII OR TlNCTURE OF 

Stramonium. Dose, 10 to 20 minims; of 
the British tincture, 5 to 15 minims. 

TlNCTURA STROPHANTHI OR TlNCTURE OF 

Strophanthus. Strength was doubled in 
the last revision. Dose, 5 to 10 minims; of 
the British, 10 to 30 minims. 

TlNCTURA TOLUTANA OR TlNCTURE OF 

Tolu. Strength was doubled in the last 
revision. Added to expectorant mixtures in 
chronic bronchitis. Dose, y 2 to 2 flui- 
drachms. 

Tinctura Valerianae or Tincture of 
Valerian. Dose, 1 to 4 fluidrachms. 

Tinctura Valerianae Ammoniata or 
Ammoniated Tincture of Valerian. Em- 
ployed as an antispasmodic in hysteria and 
other nervous troubles. Dose, 30 minims 
to a fluidrachm. 

Tinctura Vanillae or Tincture of 
Vanilla. Forms the so-called fluidextract 
of vanilla. Used as a flavoring agent, and 
to make vanilla syrup. 

Tinctura Veratri or Tincture of Vera- 
trum. Dose, 10 to 30 minims. 

Tinctura Zingiberis or Tincture of 
Ginger. A useful carminative addition to 
tonic and purgative infusions. Dose, 8 to 
40 minims. 

Tragacantha or Tragacanth. A gummy 
exudation of Astragalus gummifer, found in 



Asia Minor. Demulcent but not easily 
soluble ; used in pharmacy as a vehicle in 
which to suspend heavy insoluble powders ; 
to give consistence to troches, and to make 
emulsions. 

Triticum or Couch Grass. The dried 
rhizome of Agropyron repens, a troublesome 
weed growing everywhere. Much used in 
irritable bladder and cystitis. May be taken 
in unlimited quantities in the form of a 
decoction. 

Trituration of Elaterin. Elaterin, 10 
parts ; Sugar of Milk, 90 parts. An excel- 
lent means of administering elaterin. Dose, 
Ya to % of a grain. The British trituration 
is 2y 2 parts of Elaterin to 97 l / 2 parts of 
Sugar of Milk ; and the dose is 1 to 4 grains. 

Trochisci or Troches. Lozenges or 
small, dry masses of a flattened shape, com- 
posed largely of powders mixed with sugar 
and mucilage. Some troches have a fruit 
basis ; others with a rose basis, a tolu basis, 
or a simple basis of sugar and gum acacia. 

Trochisci Acidi Tannici or Troches of 
Tannic Acid. Tannic Acid, 6 grammes'; 
Sugar, 65 grammes ; Tragacanth, 2 grammes ; 
Stronger Orange Flower Water, to make 
100 troches. Used in relaxation of the 
uvula or in chronic angina. Slowly dissolve 
one troche in the mouth. One grain of acid 
in each. 

Trochisci Ammonii Chloridi or Troches 
of Ammonium Chloride. Ammonium Chlo- 
ride, 10 grammes; Extract of Glycyrrhiza, 
20 grammes ; Tragacanth, 2 grammes ; 
Sugar, 40 grammes ; Syrup of Tolu, to make 
100 troches. Used in congested states of 
the pharynx and larynx. 

Trochisci Cubebae or Troches of Cubeb. 
Oleoresin of Cubeb, 2 grammes ; Oil of Sas- 
safras, 1 cubic centimeter ; Extract of Gly- 
cyrrhiza, 25 grammes ; Acacia, 12 grammes ; 
Syrup of Tolu, to make 100 troches. There 
is Y\ of a minim of cubeb in each lozenge. 
Used in chronic cough, or in ulceration or 
chronic inflammation of the fauces. 

Trochisci Gambir or Troches of Gam- 
bir. Gambir, 6 grammes ; Sugar, 65 grammes ; 
Tragacanth, 2 grammes ; Stronger Orange 
Flower Water, to make 100 grammes. Used 
in prolapsus of the uvula and relaxation of 
the fauces. 

Trochisci Glycyrrhizae et Opii or 
Troches of Glycyrrhiza and Opium. Ex- 
tract of Glycyrrhiza, 15 grammes ; Powdered 
Opium, y 2 gramme ; Acacia, 12 grammes ; 
Sugar, 20 grammes; Oil of Anise, 2-10 cubic 
centimeter; Water, to make 100 grammes. 
Similar to Wistar's Cough Lozenges. De- 
mulcent and anodyne ; useful in allaying 
cough. 



824 



MATERIA MEDICA. 



Trochisci Krameriae or Troches of 
Krameria. Extract of Krameria, 6 grammes ; 
Sugar, 65 grammes ; Tragacanth, 2 grammes ; 
Stronger Orange Flower Water, to make 
100 troches. Astringent troches to be used 
in chronic angina. 

Trochisci Pot'assii Chloratis or Tro- 
ches of Chlorate of Potassium. Potas- 
sium Chlorate, 15 grammes; Sugar 60 
grammes ; Tragacanth, 3 grammes ; Water, 
to make 100 troches. Largely used in cases 
of sore throat. 

Trochisci Santonini or Troches of 
Santonin. Santonin, 3 grammes; Sugar, 90 
grammes ; Tragacanth, 3 grammes ; Stronger 
Orange Flower Water, to make 100 grammes. 
An excellent vermifuge and anthelmintic. 
Dose for a child of two years, 1 to 2 troches. 

Trochisci Sodii Bicarbonatis or Troches 
of Sodium Bicarbonate. Sodium Bicar- 
bonate, 18 grammes; Sugar, 54 grammes; 
Myristica (nutmeg), 1 gramme; Mucilage of 
Tragacanth, to make 100 troches. Antacid 
and antilithic ; used in heartburn and uric 
acid gravel. 

Ulmus or Slippery Elm. The dried 
bark of Ulmus fulva, found in the northern 
and western parts of the United States. An 
excellent demulcent ; used in dysentery, 
diarrhoea, and diseases of the urinary pas- 
sages. Used also as a poultice of the pow- 
dered bark in cases of external inflammation. 

Ung-uenta or Ointments. Fatty sub- 
stances of a butter-like consistence contain- 
ing medicinal agents to be applied by inunc- 
tion. The bases are usually lard, petrola- 
tum, hydrous wool-fat, or simple ointment. 

Unguentum or Simple Ointment. White 
Wax, 200 grammes ; Benzoinated Lard, 800 
grammes. A mild dressing to blistered or 
excoriated surfaces and is the basis of many 
ointments. 

Unguentum Acidi Boraci or Boric Acid 
Ointment. Boric Acid, 100 grammes; 
Paraffine, 100 grammes; White Petrolatum, 
800 grammes. 

Unguentum Acidi Tannici or Tannic 
Acid Ointment. Tannic Acid, 20 grammes ; 
Glycerine, 20 grammes ; Ointment, 60 
grammes. Used in piles, prolapsus ani, and 
in flabby ulcers. 

Unguentum Aquae Rosae or Ointment 
of Rose Water. Spermaceti, 125 grammes ; 
White Wax, 125 grammes ; Expressed Oil 
of Almond, 560 grammes ; Sodium Borate, 
5 grammes ; Stronger Rose Water, 190 
cubic centimeters. Used in chapped lips 
and hands. A form of cold cream. 

Unguentum Belladonnae or Bella- 
donna Ointment. Extract of Belladonna 



Leaves, 10 grammes; Diluted Alcohol, 5 
cubic centimeters; Hydrous Wool-fat, 20 
grammes; Benzoinated Lard, 65 grammes. 

Unguentum Chrysarobini or Chrysa- 
robin Ointment. Chrysarobin, 6 grammes ; 
Benzoinated Lard, 94 grammes. Used in 
psoriasis, ringworm, and other skin diseases. 

Unguentum Diachylon or Diachylon 
Ointment. Lead Plaster, 50 grammes; Oil 
of Lavender Flowers, 1 gramme; Olive Oil, 
49 grammes. Used in eczema. 

Unguentum Gallae or Nutgall Oint- 
ment. Nutgall, 20 grammes; Ointment, 80 
grammes. Used in piles, prolapsus ani, and 
flabby and indolent ulcers. 

Unguentum Hydrargyri, Mercurial 
Ointment or Blue Ointment. Mercury, 
500 grammes; Oleate of Mercury, 20 
grammes; Prepared Suet, 230 grammes; 
Benzoinated Lard, 250 grammes. Half to 
1 drachm is used at one application ; used 
in chronic glandular swellings, erysipelas, 
and chilblains. 

Unguentum Hydrargyri Ammoniati or 
Ointment of Ammoniated Mercury. Am- 
moniated Mercury, 10 grammes; White 
Petrolatum, 50 grammes ; Hydrous Wool- 
fat, 40 grammes. Used in skin eruptions, 
as in psora, porrigo, and herpes. 

Unguentum Hydrargyri Nitratis, Oint- 
ment of Mercuric Nitrate or Citrine 
Ointment. Mercury, 70 grammes; Nitric 
Acid, 175 grammes; Lard, 760 grammes. 
A stimulant and alterative application in 
porrigo, tinea capitis, chronic eczema, in- 
flammation of the eye and eyelids, and other 
ulcerative and eruptive affections. 

Unguentum Hydrargyri Oxidi Flavi or 
Ointment of Yellow Mercuric Oxide. 
Yellow Mercuric Oxide, 10 grammes ; Water, 
10 grammes ; Hydrous Wool-fat, 40 grammes ; 
Petrolatum, 40 grammes. Same effects as 
the following ointment. 

Unguentum Hydrargyri Oxidi Rubri or 
Ointment of Red Oxide of Mercury. Red 
Oxide of Mercury, 10 grammes; Water, 10 
grammes ; Hydrous Wool-fat, 40 grammes ; 
Petrolatum, 40 grammes. Used in indolent 
and foul ulcers, diseases of the scalp, and 
in conjunctival ophthalmia. 

Unguentum Iodi or Iodine Ointment. 
Iodine, 4 grammes ; Potassium Iodide, 4 
grammes ; Glycerine, 12 grammes ; Benzoin- 
ated Lard, 80 grammes. Used in goitre, 
scrofulous swelling of the glands, and 
chronic swellings. 

Unguentum Iodoformi or Iodoform 
Ointment. Iodoform, 10 grammes; Lard, 
90 grammes. 



MATERIA MEDICA. 



825 



Unguentum Phenolis, Ointment of 
Phenol or Ointment of Carbolic Acid. 
Phenol, 3 grammes; White Petrolatum, 97 
grammes. 

Unguentum Picis Liquidae or Tar Oint- 
ment. Tar, 500 grammes ; Yellow Wax, 
150 grammes; Lard, 350 grammes. Used in 
scaly and scabby eruptions, psoriasis, lepra, 
and scaldhead. 

Unguentum Potassii Iodidi or Oint- 
ment of Potassium Iodide. Potassium 
Iodide, 10 grammes; Potassium Carbonate, 
.6 gramme; Water, 10 grammes; Benzoin- 
ated Lard, 80 grammes. Used in goitre, 
scrofulous tumors, and other indolent swell- 
ings. 

Unguentum Stramonii or Stramonium 
Ointment. Extract of Stramonium, 10 
grammes ; Diluted Alcohol, 5 cubic centi- 
meters ; Hydrous Wool-fat, 20 grammes ; 
Benzoinated Lard, 65 grammes. An ano- 
dyne application in irritable ulcers, painful 
hemorrhoids, and some cutaneous eruptions. 

Unguentum Sulphuris or Sulphur 
Ointment. Washed Sulphur, 150 grammes; 
Benzoinated Lard, 850 grammes. A specific 
for the itch, applied every night over the 
entire body until the complaint is cured. 

Unguentum Veratrinae or Veratrine 
Ointment. Veratrine, 4 grammes ; Ex- 
pressed Oil of Almonds, 6 grammes ; Ben- 
zoinated Lard, 90 grammes. 

Unguentum Zinci Oxidi or Zinc 
Ointment. Zinc Oxide, 200 grammes ; 
Benzoinated Lard, 800 grammes. A mild 
astringent ointment in chronic ophthalmia, 
cutaneous eruptions, sore nipples, other ex- 
coriation or ulceration. 

Unguentum Zinci Stearatis or Oint- 
ment of Zinc Stearate. Zinc Stearate, 50 
grammes ; White Petrolatum, 50 grammes. 
Similar in effect to Zinc Ointment. 

Uva Ursi or Bearberry. The dried leaves 
of Arctostaphylos uva-ursi, found in moun- 
tainous districts. Astringent, tonic, and 
with direct effect upon the urinary organs. 
Used in gravel, chronic nephritis, ulcera- 
tion of the kidneys, bladder, or urinary pas- 
sages ; in catarrh of the bladder, inconti- 
nence of urine, leucorrhcea, and menor- 
rhagia. Dose of the powder, 20 grains to 1 
drachm. 

Valeriana or Valerian. The dried rhi- 
zome and roots of Valeriana officinalis, 
found in Europe. A gentle stimulant, espe- 
cially directed towards the nervous system, 
but not narcotic. Used in hysteria, hypo- 
chondriasis, hemicrania, and low fevers. 
See Fluidextract of Valerian. 



Vanilla. The cured, immature fruit of 
Vanilla planifolia, found in the West Indies, 
Mexico, and South America. It owes its 
properties to Vanillinum or Vanillin. Used 
for flavoring purposes. 

Veratrina or Veratrine. Alkaloids ob- 
tained from the seed of Asagraea officinalis. 
Locally irritant, with a peculiar effect upon 
the nervous system. Used in gout, rheuma- 
tism, neuralgia, epilepsy, sprains, and bruises. 
Dose, l-30th of a grain. 

Veratrum. The dried rhizome and root 
of Veratrum viride, found in the United 
States and known as Hellebore. Used to 
reduce arterial excitement, and to quiet 
spinal spasms. Dose, 2 grains. 

Viburnum Opulus or Cramp-Bark. The 
dried bark of Viburnum opulus, cranberry 
tree or high bush cranberry. Very rarely 
employed in medicine ; the berries are anti- 
scorbutic. Dose of the bark, 30 to 60 grains. 

Viburnum Prunifolium or Black Haw. 
The dried bark of Viburnum prunifolium, 
stagbush or sheepberry. Used in dysmen- 
orrhea, after-pains, and ovarian irritation. 
Dose, 30 to 60 grains. 

Vimum Antimonii or Wine of Anti- 
mony. Antimony and Potassium Tartrate, 
4 grammes ; Boiling Water, 65 cubic centi- 
meters; Alcohol, 175 cubic centimeters; 
White Wine, to make 1,000 cubic centi- 
meters. Dose as an expectorant or a dia- 
phoretic, 10 to 30 minims; as an emetic for 
children, 30 minims to 1 fluidrachm. 

Vinum Cocae or Wine of Coca. Fluid- 
extract of Coca, 65 cubic centimeters ; Alco- 
hol, 75 cubic centimeters ; Sugar, 65 
grammes; Red Wine, to make 1,000 cubic 
centimeters. Used as a stimulating tonic in 
debility and in convalescence from fevers. 
Dose, 2 to 8 fluidrachms. 

Vinum Colchici Seminis or Wine of 
Colchicum Seed. Fluidextract of Colchi- 
cum Seed, 100 cubic centimeters; Alcohol, 
150 cubic centimeters; White Wine, 750 
cubic centimeters. Dose, 30 minims to 2 
fluidrachms. 

Vinum Ergotae or Wine of Ergot. 
Fluidextract of Ergot, 200 cubic centi- 
meters ; Alcohol, 50 cubic centimeters ; 
White Wine, 750 cubic centimeters. Dose, 
2 to 4 fluidrachms. 

Vinum Ferri or Wine of Iron. Iron 
and Ammonium Citrate, 40 grammes ; Tinc- 
ture of Sweet Orange Peel, 60 cubic centi- 
meters ; Syrup, 100 cubic centimeters; 
White Wine, to make 1,000 cubic centi- 
meters. Dose, 1 fluidrachm, 



826 



MATERIA MEDICA. 



Vinum Ferri Amarum or Bitter Wine 
of Iron. Soluble Iron and Quinine Citrate, 
50 grammes; Tincture of Sweet Orange 
Peel, 60 cubic centimeters; Syrup, 300 cubic 
centimeters; White Wine, to make 100 cubic 
centimeters. A mild iron tonic. Dose, 2 
to 4 fluidrachms. 

Vinum Ipecacuanhae or Wine of Ipecac. 
Fluidextract of Ipecac, 100 cubic centi- 
meters; Alcohol, 100 cubic centimeters; 
White Wine, 800 cubic centimeters. Dose, 
as an emetic for an adult, 1 fluidounce ; as 
an expectorant and a diaphoretic, 10 to 30 
minims. As an emetic for a. child one or 
two years old, 1 fluidrachm may be given, 
and repeated every 15 minutes until it 
operates. 

Vinum Opii or Wine of Opium. Opium, 
100 grammes; Saigon Cinnamon, 10 
grammes; Cloves, 10 grammes; Alcohol and 
White Wine, of each to make 100 cubic 
centimeters. Dose, 5 to 10 minims. 

Xanthoxylum or Prickly Ash. The 
dried bark of Xanthoxylum Americanum or of 
F agar a Clava-Herculis. Stimulant and some- 
what diaphoretic. Given in chronic rheuma- 
tism and toothache. Dose, 15 to 30 grains. 

Zea or Corn Silk. The fresh silk from 
Zea mays or Indian corn. A mild stimu- 
lant diuretic used in acute and chronic 
cystitis and bladder irritation. Dose, 1 to 
3 drachms. 

ZlNCI ACETAS OR ZlNC ACETATE. A local 

remedy in ophthalmia, usually in a strength 
of 1 to 2 grains to a fluidounce of water. 

Zinci Bromidum or Zinc Bromide. Of 
slight medicinal value. Dose, 1 to 2 grains. 

Zinci Iodidum or Zinc Iodide. Used in 
the form of the syrup. As an external 
application, it is used in the strength of 
from 1 to 2 grains to a fluidounce of water. 



Zinci Oxidum or Zinc Oxide. Antispas- 
modic and astringent ; used in chorea, epi- 
lepsy, whooping cough, and gastric and 
intestinal catarrhs. Externally it is used 
in several skin diseases, preferably applied 
as the ointment. Dose, 2 to 5 grains. 

Zinci Phenolsulphonas or Zinc Phe- 
nolsulphonate. An antiseptic, astringent, 
stimulant to foul ulcers, and inflammations 
of the mucous membranes. Internally it is 
used as an intestinal antiseptic. Dose, 1 to 
3 grains. 

Zinci Stearas or Zinc Stearate. Used 
in eczema, acne, and other skin diseases in 
the form of powder or as an ointment. 

Zinci Sulphas or Zinc Sulphate. 
Tonic, astringent, and in large doses, emetic. 
Used in gastric catarrh ; externally as a 
styptic and as an application to indolent 
ulcers. In overdoses, an irritant poison. 
Dose, yi to y 2 grain; as an emetic, 10 to 
30 grains ; as a wash or outward application, 
from 1 to 3 grains in 1 fluidounce of 
water. 

Zinci Valeras or Zinc Valerate. Anti- 
spasmodic ; and useful in diabetes insipidus, 
neuralgia, epilepsy, and chlorosis. Dose, 1 
to 2 grains. 

Zingiber or Ginger. The dried rhizome 
of Zingiber officinale, found in Hindostan, 
and all parts of India, in the West Indies, 
and at Sierra Leone in Africa. A grateful 
stimulant and carminative ; often given in 
dyspepsia, flatulent colic, atonic gout ; ex- 
ternally a rubefacient. Infusion of ginger 
is made by adding half an ounce of the 
powdered or bruised root to a pint of boil- 
ing water. Of this from 1 to 2 fluidounces 
may be given. Dose of the root, 10 to 20 
grains. 



BOOK XII. 

USEFUL MEDICAL KNOWLEDGE. 

EMIL BUEHLER, Ph.G. 

New York College Pharmacy; Dispensing Pharmacist Northwestern Hospital, New York City. 

FAMILY MEDICINE CHEST. * 

A small, well-chosen assortment of medicines will be found a 
great comfort and convenience in cases of sudden illness or accident. 
Not only will such afford temporary relief to the sufferer, but it will 
be a means of relieving the anxiety of friends until the doctor comes. 
In cases of remoteness from either the physician or druggist, this 
becomes a necessity, especially in households where there are chil- 
dren. From this assortment the physician can draw, and so prevent 
the delay and inconvenience of a trip to the drug store. 

A very great deal of latitude can be indulged and a great range 
of choice exercised in the selection. Those which appear below will 
be found to be very practical and convenient in all the cases which 
are likely to arise in a home, and will cover almost all emergencies. 
The following points are well worthy of attention in making up a 
medicine chest: — 

i. Do not buy large quantities. Regard of this point will not 
only reduce the cost of the outfit, but will insure freshness of such 
as are likely to deteriorate by age and exposure to the air. 

2. Keep the supply always under lock and key so that children, 
proverbially curious, may not have access to it. Under no circum- 
stances should medicines be allowed to stand exposed on mantels, 
bureaus, pantry and closet shelves, or in drawers among other 
articles. This is a precaution not only against accident, but to 
enable one to find them quickly in cases of emergency. Many 
medicines deteriorate in the light, others under the effects of heat; 
so that a cool, dark location is desirable for the medicine closet. 

3. Let each preparation be kept in a bottle — solids and powders 
in wide-mouthed bottles — with good fitting corks and properly and 
legibly labeled. 

4. The labels should bear the name of the medicine and the dose 
very plainly marked. If the label becomes obliterated or soiled, 
put on a new one at once. When pouring out a dose of liquid 
medicine, keep the label side of the bottle turned up so that the 
overflow or drip will not run down on the label. 



828 USEFUL MEDICAL KNOWLEDGE. 

5* If a cork becomes broken or much stained with the medicine, put 
a new one in its place at once. Never exchange the corks of bottles. 

6. When new supplies are added, do not put new drugs in bottles 
that have been used for other preparations. Great danger of confusion 
may result. 

When a dose of medicine is to be given, the following points should 
be carefully observed to guard against serious errors : — 

1. Read the label very carefully. Pour out the dose required. Then 
read the label again to make assurance doubly sure. 

2. Never pour a dose of medicine in the dark or in imperfect light, 
no matter how well you may feel that you know the chest and its con- 
tents. Fatal results have followed this carelessness. 

3. Always shake the bottle before pouring out a dose. 

4. When drops of medicine form a dose, use the medicine dropper; 
and always rinse it in water before and after using. 

5. Immediately replace a bottle in its proper place in the chest after 
using. If you wait until you have more time, you will probably forget 
it, and there is a risk that a child may get it before you return. 

6. Keep poisonous preparations in a different sort of bottle to impress 
you at the time of using that they are poisonous and so to instill care in 
handling them, and also to enable you to find them more easily on going 
to the chest. Your druggist will gladly assist on this point. 

7. The doses of medicines given in the Materia Medica are for adults ; 
consult "Useful Hints and Information" on how to gauge a child's 
dose. 

Contents of the Medicine Chest. — This list may be varied accord- 
ing to the needs or ability of a family. Some may be omitted; others 
may be added. 

Aconite, tincture of. Chloroform liniment. 

Alcohol. Cod-liver oil. 

Alum. Collodion. 

Ammonia. Copper sulphate. 

Arnica, tincture of. Creolin. 

Aromatic spirits of ammonia. Digitalis, tincture of. 

Asafcetida, tincture of. Dover's powder. 

Belladonna, tincture of. Epsom salts. 

Bichloride of mercury. Flaxseed meal. 

Bismuth, subnitrate of. Formalin. 

Boric acid. Ginger, essence of. 

Bromide of potash. Glycerine. 

Calomel. Iodine, tincture of. 

Camphor. Iodoform. 

Carbolic acid. Ipecac, syrup of. 

Carron oil. Iron sulphate. 

Cascara sagrada. Laudanum. 

Castor oil. Lead, sugar of. 



GLOSSARY. 



829 



Limewater. 

Mustard. t 

Paregoric. 

Peppermint, essence of. 

Pepsin, essence of. 

Peroxide of hydrogen. 

Potassium chlorate. 

Potassium permanganate. 

Quinine. 

Rochelle salts. 

Rhubarb, powdered. 

Rhubarb, syrup of. 

Salicylic acid. 

To these should be added such aids as : — 

Mustard plasters. 
Glycerine suppositories. 
Cold cream. 
Vaseline. 

Carbolated vaseline. 
Fountain syringe. 
Hot water bottle. 



Seidlitz powder. 

Silver nitrate. 

Soda mint. 

Sodium bicarbonate. 

Squill, syrup of. 

Sulphur. 

Sweet spirits of niter. 

Talcum powder. 

Turpentine. 

Witch hazel. 

Zinc oxide. 

Zinc sulphate. 



Oil silk. 

Cloths for bandages. 

Cloths for poultices. 

Atomizers. 

Absorbent cotton. 

Medicine glasses. 

Medicine dropper. 



GLOSSARY OF MEDICAL AND OTHER TERMS. 



Note. — Words which are explained in the 

text are not repeated here. They are to be 

found by consulting the Index. 

Ab-do' -men. The belly, or the lower part of 
the body below the diaphragm. 

Ab-lu'-tion. Cleansing by water; washing 
of the body externally. 

Ab-nor'-mal. Unnatural ; not according to 
rule ; irregular. 

A-bra'-sion. A superficial wound produced 
by rubbing off the skin. 

Ab-sorb'-ent. Glands and vessels which ab- 
sorb or suck up substances from within 
or without ; also medicines which absorb, 
or combine with acid matter in the stom- 
ach or bowels. 

Ac-couch-eur' (ak-koosh-ur'). A man who 
attends women in childbirth. 

A-cho'-li-a. Deficiency of bile. 

Ac'-id. Acrid ; sour, sharp, pungent, bitter, 
or biting to the taste. 

Ac'-tu-al Cau'-ier-y. Burning or searing with 
a hot iron; used in surgery. 

Ac-u-punc'-ture (ak-u-punk'-ture). Prick- 
ing with needles ; one of the operations 
of surgery. 

A-cute' '. Diseases of short duration, at- 
tended with violent symptoms ; the re- 
verse of chronic. 

Ad-he' -sive. Tenacious, sticky; tending to 
adhere. 

Ad'-i-pose. Matter, membrane or tissue; 
fat. 

Ad'-ju-vant. A substance added to a pre- 
scription to aid the operation of the prin- 
cipal ingredient. 

A-dult' Age. A person grown to full size 
or strength ; manhood or womanhood. 

Af-fec'-tion. Disorder, disease, malady. 



Al-bu' -mi-nose. A substance produced in 

the stomach during digestion. 
Al'-i-ment. Nourishment, nutrition ; any- 
thing necessary for the support of life. 
Al-i-ment'-a-ry Ca-naU '. The tube by which 

aliments are conveyed through the body ; 

it is composed of the mouth, pharynx, 
oesophagus, stomach, and intestines. 
AV-ka-li (li or le). A substance which, 

when united to acids, neutralizes them. 
Al'-ter-a-tive. A remedy which slowly 

changes the condition of the system. 
Al-ye'-o-lar. Relating to the sockets of the 

teeth. 
Al'-vine. Relating to the intestines. 
Am-aur-o'-sis. A loss or decay of sight, 

produced by various causes. 
A-meV '-i-o-ra' '-tion. Becoming better ; im- 
provement in stages of a disease. 
Am-ni-ot'-ic Liquid. The fluid surrounding 

the foetus in the womb. 
Am-pu-ta'-tion. The operation of cutting 

off a limb or other part of the body. 
An-aem'-i-a. Poverty of blood ; a compara- 
tively bloodless state. 
An-aes-the'-sia. Numbness or paralysis of 

sensation. 
An-aes-thet'-ics. Agents that temporarily 

destroy sensation. 
A-na-sar'-ca. A dropsy of the whole body ; 

a general dropsy. 
A-nas'-to-mose. To communicate with each 

other; applied to arteries and veins. 
An'-eu-rism. A soft tumor, caused by the 

rupture of the coats of an artery. 
An-i-mal' -cules. Animals so small as to be 

visible only with a microscope. 
Ant'-ac-id. A substance which neutralizes 

acids; alkalies are antacids. 



8 3 o 



USEFUL MEDICAL KNOWLEDGE. 



An'-thrax. A dusky red or purplish kind of 
tumor, occurring in the neck. 

An-ti-bil'-ious (an-ti-bil'-yus). A medicine 
counteractive of bilious complaints. 

An'-ti-dote. A protective against, or remedy 
for, poison or any disease. 

An-ti-dys-en-ter'-ic (an-ti-dys-in-ter'-ik). A 
remedy for dysentery. 

An-ti-e-meV '-ic (an-ti-e-met'-ik). A remedy 
to check or allay vomiting. 

An-ti-lith'-ic (an-ti-lith'-ik). A medicine to 
prevent or remove urinary calculi or 
gravel. 

An-ti-mor-bif -ic. Anything to prevent or 
remove disease. 

An-ti-phlo-gis'-tic. Any medicine which re- 
duces inflammation. 

An-ti-scor-bu'-tic. A remedy used for the 
scurvy. 

An-ti-sep'-tic (an-ti-sep'-tik). Whatever re- 
sists or removes putrefaction or mortifi- 
cation. 

An-ti-si-al'-ic. Any agent that reduces the 
flow of saliva. 

An-ti-zy-mot' -ic . A disinfectant or antisep- 
tic used in processes of fermentation. 

A'-nns. The orifice of the alimentary canal, 
of which it is the outlet. 

A-or'-ta. The great artery from the heart. 

Ap'-a-thy. Insensibility to mental or bodily 
pain. 

A'-pex. The top or summit. 

A-pha'-si-a. A lack of the power of speech, 
caused often by an attack of apoplexy. 

A-pho'-nia. A loss of the voice. 

Ap'-pe-tite. A desire for food or drink. 

A-ro'-ma. Agreeable odor of plants and 
other substances. 

Ar-o-mat'-ic. A fragrant, spicy medicine. 

Ar'-te-ry. A vessel that conveys the blood 
from the heart to the organs. 

Ar-thro'-di-a. A joint movable in every 
direction. 

Ar-tic'-u-lat-ed. Having joints. 

Ar-tic-u-la' '-tion. The union of bones with 
each other, as at the joints. 

As-car'-i-des. Pinworms or threadworms 
found in the lower portion of the bowels. 

As-ci'-tes. Dropsy of the abdomen. 

As-phyx'-ia. Suspended animation ; appar- 
ent death, as from drowning. 

As-then'-ic. Debilitated. 

At'-o-ny. Debility ; want of tone ; defect of 
muscular power. 

At'-ro-phy. A wasting of flesh and loss of 
strength without any sensible cause. 

At -t en' -u- ants. Medicines for reducing the 
body. 

Au'-ri-cle. A cavity of the heart. 

Ax-il'-la. The armpit ; hence axillary, per- 
taining to the armpit. 

Ax'-il-la-ry Glands. Situated in the armpit, 
secreting a fluid of peculiar odor. 

Balsam' -ics. Medicines employed for heal- 
ing purposes. 



Bi-en'-ni-al. Continuing alive for two years. 

Bile or Gall. A fluid secreted by the liver, 
which promotes digestion. 

Blis'-ter. A thin watery bladder on the skin. 

Bou-gie' (boo-zhe')- A taper body intro- 
duced into a passage or sinus to keep it 
open or enlarge it. 

Bron'-chi-al. Pertaining to the branches of 
the windpipe in the lungs. 

Bul'-bous. Round or roundish. 

Ca-chex'-y (ka-keks'-y). A bad state of the 
body. It may be caused by blood poisons. 

Cal'-lous. Hard or firm. 

Ca-lor'-ic. Heat. 

Cap'-il-la-ry. Fine, hair-like. 

Ca'-ri-es. Ulceration of a bone. 

Ca-rot'-id Artery. The great arteries of the 
neck that convey blood to the heart. 

Car'-ti-lage. A hard elastic substance of the 
body ; gristle. 

Cat-a-me'-ni-a. The menses, or monthly 
discharges of women. 

Cath'-e-ter. A curved instrument intro- 
duced into the bladder through the ure- 
thra for drawing off the urine. 

Cans' -tic. Burning ; a substance which burns 
or corrodes living tissues. 

Cau'-ter-y. A burning or searing any part of 
the animal body. 

Cer'-e-bral. Relating to the brain. 

Cer'-e-bral-De-press'-ant. Lowers and de- 
creases excitement of cerebrum. 

Cer'-e-bral-Ex-cit'-aut. Stimulates and in- 
creases activity of cerebrum. 

Cer'-e-bro-Spi'-nal. Pertaining to the brain 
and spinal cord. 

Ce-ru'-men. The ear wax. 

Cha-lyb' -e-ate (ka-lib'-e-ate). Containing 
iron in solution, as occurring in mineral 
springs. 

Chol'-a-gogues. Medicines that increase the 
flow of bile, as calomel and podophyllin. 

Chol'-er-ic (koP-er-ic). Easily irritated; ir- 
ritable. 

Chron'-ic. Continuing for a long time, and 
becoming a fixed condition of the body. 

Ci-ca'-trix. A scar that remains after a 
wound. 

Cir-cu-la'-tion. The motion of the blood, 
which is propelled by the heart through 
the body. 

Cli-mac'-ter-ic. A term generally applied to 
the time at which the menses finally 
cease. 

Clys'-ter. An injection; a liquid substance 
thrown into the lower intestine. 

Co-ag'-u-la'-tion. A change from a fluid to 
a solid condition, as in the coagulation of 
the blood. 

Co-ag'-u-lum. A clot of blood. 

Co-a-lesce' (ko-a-les r ). To grow together; 
to unite. 

Col-lapse'. Sudden failure or prostration of 
the vital functions. 

Col-liq'-ua-tive (kol-lik'-wa-tiv). Excessive 



GLOSSARY. 



831 



discharges from the body which weaken 

the system. 
Co'-lon. A portion of the large intestine. 
Co' -ma, Co'-ma-tose. Lethargy ; disposed 

to sleep ; stupor. 
Com' -press. Several folds of linen rags ; a 

bandage. 
Con-cas'-sion (kon-kush'un). A violent 

shock, as of the brain. 
Con'-ftu-ent. Running together. 
Con-gen' -i-tal. From birth, or born with. 
Con-ges'-tion (kon-jest'-yun). Distention 

of any part by an accumulation of blood. 
Con-junc-ti'-va. The membrane which 

lines the eyelid and covers the eye. 
Con-sti-pa'-tion. Costiveness ; obstruction 

or hardness of the contents of the intes- 
tines. 
Con-ta'-gious. Catching, or that may be 

communicated by contact. 
Con-tu'-sion. A bruise. 
Con-va-les'-cence. Gradual return to health 

after sickness. 
Con-vul'-sions. Involuntary and violent 

movements of the body. 
Cor'-dial. A medicine that mildly stimu- 
lates and raises the spirits. 
Cor'-ne-a. The transparent membrane in 

the forepart of the eye. 
Cor-ro'-sive. Substances that consume or 

eat away. 
Coun'-ter-ir-ri-ta'-tion. Drawing disease 

from one part by irritating another 

part. 
Cri'-sis. The turning point of a disease. 
Cu-ta'-ne-ous. Pertaining to the skin, as 

cutaneous diseases. 
Cu'-ti-cle (ku'-ti-kl). The outer or scarf 

skin. 
Cyst. A bag or sac containing matter or 

other fluid. 
De-bil'-i-ty. Weakness. 
De-coc'-tions (de-kok'-shuns). Medicines 

prepared by boiling. 
Deg-lu-ti'-tion. The act of swallowing. 
Del-e-te'-ri-ous. That which is hurtful. 
De-lir'-i-ants. A narcotic wnich produces 

delirium. 
De-lir'-i-um. Wildness or wandering of 

the mind. 
Den'-ti-frice. Medicated pastes or powders 

for cleansing the teeth and gums. 
Den-ti'-tion. Teething. 

De-ob'-stru-ent. A mild laxative ; an aperi- 
ent. 
De-ple'-tion. Diminution of the quantity of 

blood by blood-letting or ocher process. 
Dep'-u-ra-tion. Cleansing from impure 

matter. 
Derm. The natural tegument or covering of 

an animal. 
De-ter'-gent. A medicine that cleanses from 

offending matter. 
Di-ag-no'-sis. The act of distinguishing 

diseases by symptoms. 



Di'-a-phragm (di'-a-fram). The muscular 
division between the chest and the abdo- 
men. 

Di-ath'-e-sis. Tendency of the body to any 
form of disease, as scrofulous diathesis. 

Di-e-tet'-ic. Relating to diet or regimen. 

Dil-a-ta'-tion. Act of expanding or spread- 
ing in all directions. 

Dil'-u-ents. That which thins, weakens, or 
reduces the strength of liquids. 

Dis-cu'-tients. Medicines which scatter a 
swelling or tumor, or any coagulated fluid 
or body. 

Dis-lo-ca'-tion. . The displacement of a bone 
out of its socket. 

Dis-po-si'-tion. Tendency. 

Dor'-sal. Pertaining to the back. 

Dras'-tics. Active or strong purgatives. 

Du-o-de'-num. The first of the small intes- 
tines. 

Dys'-cra-sia. A bad habit of body produc- 
ing generally a diseased condition of the 
system. 

Dys-pha'-gi-a. Difficulty of swallowing. 

Dysp-noe'-a. Difficulty of breathing. 

Dys-u'-ri-a. Difficulty in discharging urine, 
attended with pain and heat. 

Eb-ul-li'-tion. The motion of a liquid by 
which it gives off bubbles of vapor as in 
boiling. 

Ef-fer-ves'-cence. The escape of gas from 
a fluid, as in the so-called "soda-water." 

Ef-Ho-res' -cence . Eruption or redness of 
the skin, as in measles, scarlet fever, etc. 

Ef-Hu'-vi-a. Exhalations from substances, 
as from flowers or decaying matter. 

Ef-fu'-sion. An escape of the fluids of the 
body from their natural position into the 
tissues or cavities of the body. 

E-lec-tri-za' -tion. Medical use of the elec- 
tric currents. 

E-lec'-tu-ary. Medicines mixed with honey 
or syrup. 

E-lim-i-na' -tion. Discharged from the body, 
as by the pores of the skin. 

E-ma-ci-a'-tion. Wasting away of the flesh. 

Em'-bry-o. The early stage of the foetus. 

Em'-e-sis. Vomiting. 

E-met'-ics. Medicines given to cause vomit- 
ing. 

E-mol'-li-ent. A softening application which 
allays irritation. 

E-mul'-sion. A mixture ; as oil and water 
mixed with mucilage or sugar. 

En-ceph'-a-lon. The whole of the brain. 

En-cyst'-ed. Inclosed in a cyst or sac. 

En-dem'-ic. A disease peculiar to a certain 
district. 

En-er-va'-tion. A loss of nervous tone and 
reduction of strength. 

En-te-ri'-tis. Inflammation of the bowels. 

En-to-so'-a. Intestinal worms living in 
some part of an animal body. 

E-phem'-e-ral. Of short duration. 

Ep-i-dem'-ic. A disease that prevails. 



8 3 2 



USEFUL MEDICAL KNOWLEDGE. 



Ep-i-derm'-is. The scarf skin; the cuticle. 

Ep-i-gas'-tric. Pertaining to the upper and 
anterior part of the abdomen. 

Ep-i-glot'-tis. A leaf -shaped cartilage, 
whose use is to prevent food or drink 
from entering the larynx and obstructing 
the breath while eating. 

E-piph'-o-ra. An overabundant secretion of 
tears, causing what is termed a watery- 
eye. 

Ep-i-spas'-tic. An application for blister- 
ing. 

Ep-is-tax'-is. Bleeding from the nose. 

Ep-i-the'-li-um. A layer of cells covering 
membranes. 

Er'-e-thism. Morbid, energetic action of 
irritability. 

E-ro'-sion. «Eating away ; corrosion. 

Er'-rhine (er'-rin). A medicine for snuffing 
up the nose to promote the discharge of 
mucous. 

E-ruc-ta'-tion. Belching; gulping of wind 
from the stomach. 

E-rup'-tion. A breaking out on the skin. 

Es'-char (es'-kar). The dead part, killed by 
caustic or mortification, which falls off. 

Es-cha-rot'-ic. Caustic ; an application 
which sears or destroys the flesh. 

Eu-sta' -chi-an tube (yu-sta'-ki-an). A nar- 
row canal eonnecting the middle ear and 
throat. 

E-vac-u-a'-tion. Movement of the bowels, 
or passing of urine from the bladder. 

Ex-ac-er-ba'-tion (egz-as-er-ba'-shun). In- 
crease of severity in a disease. 

Ex-an-the' -ma. An eruptive disease, with 
fever, as smallpox, measles. 

Ex-ci' -sion. Cutting out of a part. 

Ex-cit'-ant. A stimulant. 

Ex-co'-ri-ate. To abrade or scrape off the 
skin in any way. 

Ex-cres'-cence. An abnormal or unnatural 
growth of a part, as a wart or tumor. 

Ex-cre'-tion. Waste matter thrown off from 
the system, as the perspiration, faeces, etc. 

Ex-fo'-li-ate. Scaling or peeling off ; separa- 
tion of decayed from living bone. 

Ex-ha-la'-tion. Emission of vapor, air, gas, 
etc. 

Ex-os-to'-sis. An unnatural growth from 
a bone ; a bony tumor. 

Ex-pec'-to-rant. A medicine which aids the 
discharge of phlegm from the bronchial 
tubes or lungs. 

Ex-pec-to-ra' '-tion. Discharge of phlegm, 
mucus, or saliva from the mouth. 

Ex-pi-ra'-tion. The act of breathing out the 
air from the lungs. 

Ex-trav-a-sa'-tion. Effusion ; emptying or 
forcing a fluid out of its proper vessels. 

Ex-u-da'-tion. Perspiration ; the discharge 
of moisture on the surface of bodies. 

Fae'-cal (fe'-kal). Pertaining to faeces. 

Fae'-ces (fe'-cez). The. natural discharges 
of the bowels. 



Far-a-di-za / -tion. The use of the Faradaic 
current. 

F ar-i-na' -ceous. Containing starch, as far- 
inaceous food, starchy food. 

Fau'-ces. The back part of the mouth, at 
the entrance of the throat. 

Feb'-ri-fuge. A medicine which assuages 
fever and produces perspiration. 

Fe'-brile. Having the symptoms of fever; 
feverish. 

Fem'-o-ral. Pertaining to the femur. 

Fe'-mur. The thigh bone. 

Fet'-id. Having a rank, disagreeable odor. 

Fi'-brine. Animal matter found in blood. 

Fi'-brous. Composed of small threads or 
fibers. 

Fil'-ter. A strainer. 

Fil-tra'-tion. Straining. 

Fis'-tu-la. A deep, narrow, crooked ulcer. 

Flac'-cid (flak'-sid). Soft and weak, lax, 
limber; as a flaccid muscle. 

Flat'-u-len-cy, Fla'-tus. Wind in the stom- 
ach and intestines causing uneasiness. 

Flex'-i-ble. Easily bent; yielding to pres- 
sure. 

Flood'-ing. Profuse flow of blood. 

Flush. A sudden flow of blood to the 
face. 

Flux. An unusual discharge from the 
bowels. 

Foe'-tus (fe-tus). The child in the womb. 

F o-men-ta' -tion. Bathing by means of flan- 
nels dipped in hot water or medicated 
liquid. 

For-mi-ca'-tion. A sensation like the creep- 
ing of ants. 

F or' -mu-la. A prescription. 

Fric'-tion. The act of rubbing. 

Fu-mi-ga f -tion. A vapor raised by burning. 

Func'-tion. The work or office performed by 
any part or organ of the body. 

Fun'-da-ment. The seat ; the lower ex- 
tremity of the large intestine. 

Fun f -gus. A spongy excrescence, as proud 
flesh. 

Gal-va-ni-za> '-tion. Use of the galvanic cur- 
rent. 

Gan'-gli-on (gang'-gli-on). An enlargement 
in the course of a nerve. 

Gan'-grene. Mortification or death of a 
part. 

Gar'-gle. A wash for the mouth and throat. 

Gas'-tric. Belonging to the stomach. 

Gas-tri'-tis. Fever or inflammation of the 
stomach. 

Ges-ta'-tion. The period of pregnancy. 

Gland. A soft body, the function of which 
is to secrete some fluid. 

Glot f -tis. The opening into the windpipe, 
covered by the epiglottis. 

Glu'-te-us. A name given to the muscles of 
the hip. 

Gran-u-la' '-tion. The healing of a wound or 
ulcer by the formation of grain-like fleshy 
masses. 



GLOSSARY. 



833 



Gru'-mous. Thick; clotted; concreted; as 
grumous blood. 

Gui'-tur-al. Pertaining to the throat. 

Hab'-it. A peculiar state or temperament 
of the body. 

Hec'-tic. A remitting fever, with chills, 
heat and sweat. 

Hem-a-to'-sis. An excessive or morbid 
quantity of blood. 

Hem-i-ple f -gia. Paralysis of one side of the 
body. 

He-mop' -ty-sis. A spitting of blood. 

Hem'-or-rhage. Bleeding; a flow of blood, 
as from the lungs, nose, etc. 

Hem'-or-rhoids. The piles; tubercles from 
which blood or mucus is discharged. 

He-pat'-ic. Pertaining to the liver. 

He -pat' -ic -De -press' -ants. Agents which 
lower the activity of the liver. 

Her-ba'-ceous (her-ba'-shus). Pertaining to 
herbs. 

He-red'-i-ta-ry. Descended from a parent; 
inherited. 

Her'-ni-a. A rupture, and protrusion of 
some part of the abdomen. 

Her'-pes. An eruption on the skin, as tet- 
ter, ringworm, etc. 

Hu'-mors (yu'-mors). The fluids of the 
body. 

Hy-per-es-the'-si-a. Excessive and abnor- 
mal sensibility. 

Hyp-o-chon-dri' -a-cal. Melancholy ; very 
dejected; low-spirited. 

Hy-po-der'-mic. Under the skin. 

Hys-ter'-ic-al. Nervous; subject to hys- 
teria. 

I'-chor (i'-kor). A thin, watery, and acrid 
discharge from an ulcer. 

Id'-i-op'-a-thy. A morbid condition not pre- 
ceded by any other disease. 

Id-i-o-syn'-cra-sies. Peculiarities of consti- 
tution or temperament. 

Il'-e-um. The lower part of the small in- 
testines. 

Il'-i-ac. Pertaining to the small intestines. 

Im-be-cil'-i-ty. Feebleness ; weakness of 
mind or intellect. 

In-a-ni'-tion (in-a-nish'-un). Emptiness; 
weakness ; exhaustion. 

In-dig'-e-nous. Native to a country. 

In-fec'-tion. Contagion. 

In-fu'-sion (in-fu'-zhun). Medicine pre- 
pared by boiling or steeping. 

In-ges'-tion (in-jest / -yun). Throwing into 
the stomach. 

In-jec'-tion (in-jek'-shun). Liquid sent into 
some part of the body by means of a 
syringe. 

In-oc-u-la' -tion. Communicating a disease 
to a person in health by inserting con- 
tagious matter in the skin. 

In-spi-ra'-tion. Drawing or inhaling air in- 
to the lungs. 

ln-spis-sa'-tion. Rendering a fluid thicker 
by evaporation. 



In-teg'-u-ment. A covering ; the skin. 

In-ter-cos'-tal. Between the ribs. 

In-ter-mit'-tent. Ceasing at intervals. 

In-tes'-ti-nal As-trin' -gents. Agents which 
pucker and diminish the exudation of in- 
testinal vessels. 

Ir'-ri-tants. Substances which produce in- 
flammation when applied to a part. 

Lac'-er-at-ed. Torn asunder. 

Lach'-ry-mal (lak'-ri-mal). Pertaining to 
the tears. 

Lac-ta'-tion. Act of nursing, or sucking. 

Lan'-ci-na-ting. Piercing, as with sharp 
pointed instruments ; hence lancinating 
pain. 

Lan'-guor (lang'-gwur). Feebleness, weak- 
ness, lassitude of body. 

Lar'-ynx. The upper part of the windpipe. 

Lax'-a-tive. A mild purgative ; a medicine 
that loosens the bowels. 

Le'-sion. A rupture or tearing of the flesh ; 
a wound. 

Leth'-ar-gy. Unusual or excessive drowsi- 
ness. 

Li-ga'-tion. The art of tying a vessel. 

Lig'-a-ture. A thread for tying blood ves- 
sels to prevent hemorrhage. 

Lin'-i-ment. A medicated lotion or wash ; 
a soft ointment. 

Lith'-on-trip-tic. A solvent of the stone or 
gravel in the bladder. 

Li-thot'-o-my. The operation of cutting for 
stone in the bladder. 

Liv'-id. Black and blue ? of a lead color. 

Lo'-chi-al. Pertaining to discharges from 
the womb after childbirth. 

Lum-ba'-go. Rheumatic pains in the loins 
and small of the back. 

Lum'-bar. Pertaining to the loins. 

Lymph (limf). A whitish fluid contained 
by the lymphatic vessels. 

Lym-phat'-ic (vessels). Fine tubes pervad- 
ing the body ; absorbents. 

Mac-er-a'-tion. Dissolving or softening with 
water. 

Mac'-u-lar. Colored spots ; blemishes. 

Mal-for-ma'-tion. A wrong formation or 
structure of parts. 

Ma-lig'-nant. Violent ; dangerous ; tending 
to produce death. 

Mat-u-ra'-tion. The formation of pus or 
matter in any part of the body. 

Men'stru-um. A solvent ; any liquid used to 
dissolve solid substances. 

Me-phit'-ic. Suffocating ; noxious ; pestilen- 
tial. 

Me-tas'-ta-sis. A change of disease from 
one part of the body to another. 

Mi-as'-ma, Mi-as'-ma-ta. Malaria, exhala- 
tions from swamps and decaying matter. 

Mor'-bid. Diseased ; corrupt. 

Mor-bif'-ic. Causing disease. 

Mo'-tor-De-press'-ants. Drugs which dimin- 
ish or paralyze the activity of the spinal 
cord or motor apparatus. 



834 



USEFUL MEDICAL KNOWLEDGE. 



Mo'-tor-Ex-cit'-ant. Any drug which in- 
creases the activity of the spinal cord or 
motor apparatus. 
Mu'-cus. The ropy, lubricating, tenacious 
fluid, secreted by the mucous membrane. 
Myd'-ri-at'-ic. Drugs which cause dilation 

of the pupil of the eye. 
My-ot'-ic. Drugs which cause contraction 

of the pupil of the eye. 
Nar-cot'-ics. Medicines that cause sleep, 

relieve pain, or stupefy. 
Nau'-se-a (naw'-she-a). Sickness at the 

stomach, with a desire to vomit. 
Ne-phrit'-ic. Pertaining to the kidneys. 
Ner'-vine. A medicine that acts on the 

nerves. 
Neu-ral'-gia. Pain of a nerve without 

apparent inflammation. 
Nor'-mal. Natural; regular. 
Oe-de'-ma. A watery swelling. 
Ol-fac'-to-ry Nerves. The nerves of smell. 
O-men'-tum. The caul or covering of the 

bowels. 
Dph-thal'-mi-a (of-thal'-mi-a). Inflamma- 
tion of the eyes. 
O'-pi-ates. Medicines which promote sleep. 
Op'-tic Nerve. The nerve which enters the 

back part of the eye. 
Or-thop-noe'-a. Great difficulty of breath- 
ing, caused by diseases of the heart or 

diaphragm, or asthma. 
Os'-si-fy. To change flesh or other soft 

matter into a hard, bony substance. 
O'-vum. An egg. 
Pal-pi-ta'-tion. Unnatural action of the 

heart, in which it beats too rapidly and 

strongly. 
Pan-a-ce'-a. A cure-all; a universal medi- 
cine. 
Pa-pil'-la. A red, elevated point upon the 

tongue or elsewhere. 
Par-a-cen-te'-sis. Puncturing of the chest 

or abdomen for the purpose of drawing 

off water. 
Par-a-ple'-gi-a. Paralysis of the lower half 

of the body. 
Par'-ox-ysm. A fit of disease taking place 

periodically. 
Par-tu-ri'-tion. Childbirth. 
Pec'-tor-al. Pertaining to the chest. 
Pel'-vis. A bony cavity forming the lower 

part of the trunk of the body. 
Per-i-car'-di-um. The sac inclosing the 

heart. 
Per-i-ne'-um. The space between the anus 

and the testicles. 
Per-i-os'-te-um. A thin, hard membrane 

covering the bones. 
Per-x-to-ne'-um. The membrane lining the 

abdomen and covering the bowels. 
Pe-te'-chi-ae. Purple spots which appear 

upon the skin in low fevers. 
Phag-e-den'-ic. Corroding ; eating ; applied 

to ulcers. 
Pha-lan'-ges. The bones of the fingers and 

toes. 



Phar'-ynx. The upper pan of the throat. 
Phlegm (flem). A stringy mucus of the 

respiratory and digestive passages. 
Phleg-mat'-ic. Abounding in phlegm ; cold ; 

dull ; sluggish ; heavy. 
Plilo-gis'-tic. Inflammatory. 
Phthis'-ic-al (tiz'-ik-al). A condition of 
the system tending to pulmonary con- 
sumption. 
Pleth'-or-ic. Of a full habit of body. 
Pleu'-ra. A membrane that lines the in- 
side of the chest and covers the lungs. 
Pleu'-ri-sy. Inflammation of the pleura. 

Pneu-mo'-ni-a (nu-mo'-ni-a). Inflammation 
of the substance of the lungs. 

Pol'-y-pus. A pear shaped tumor. 

Pre-scrip'-tion. The formula for the prep- 
aration of medicines. 

Probe. An instrument for examining the 
depth of a wound. 

Prog-no' -sis. The art of foretelling the ter- 
mination of a disease. 

Proph-y-lac'-tic. A medicine to prevent dis- 
ease. 

Pro-tect'-ives. Any agent used to cover an 
injured part thus excluding air, water, 
etc. 

Pty'-a-lism (ty'-a-lism). A copious flow of 
saliva; salivation. 

Pu-bes'-cent. Covered with down or very 
short hairs. 

Pul f -mo-na-ry. Pertaining to or affecting 
the lungs. 

Pun' -gent. Sharp, piercing, biting, stimulat- 
ing. 

Pu'-ru-lent. Consisting of pus or matter. 

Pus. Yellowish white matter, found in ab< 
scesses, etc. 

Pus'-tu-lant. Any agent which gives rise to 
pustules. 

Pus'-tules. Elevations of the skin having 
inflamed base and containing pus. 

Pu-tres'-cent. Becoming putrid; pertaining 
to the process of putrefaction. 

Py-ro'-sis. A peculiar disease of the stomach 
called water-brash. 

Rec'-tum. The termination of the large in- 
testine. 

Re-frig' -er-ant. Medicines which lessen the 
heat of a body. 

Reg'-i-men. The regulation of diet in order 
to preserve or restore health. 

Res-o-lu'-tion. Dispersion of an inflamma- 
tion before pus has formed. 

Re-solv'-ents. Medicines to dissipate in- 
flammation. 

Res-pi-ra'-tion. The process of breathing. 

Re-stor'-a-tive. Agents which promote 
constructive changes. 

Re-sus-ci-ta'-tion. Reviving from apparent 
death, as drowning. 

Ret'-i-na. The semi-transparent, internal 
nervous tissue of the eye. 

Ru-bif'-ic. Making red. 

Sac'-cha-rine (rin). Sugary; having the 
qualities of sugar. 



GLOSSARY. 



835 



Sa-li'-va. The spittle; the secretions of the 

salivary glands of the mouth. 
Sal-i-va'-tion. Increase of the secretion of 
saliva. 

San'-guine (san-gwin). Abounding in 
blood, or having the color thereof. 

Sa'-ni-cs. A thin, often purulent discharge 
from wounds or ulcers. 

Scab. A crust formed over a sore in healing. 

Scarf-skin. The outer skin of the body. 

Scir'-rhous (skir'-rus). Hard; knotty. 

Scor-bu'-tic. Pertaining to, or partaking of 
the nature of scurvy. 

Se-cre'-tion. The separation of any sud- 
stance from the blood for a special pur- 
pose. 

Sed'-en-ta-ry. Accustomed to or requir- 
ing much sitting ; inactive. 

Sem'-i-nal. Pertaining to, or contained in, 
seed. 

Se'-rons. Thin, watery, like whey. 

Se'-rum. The watery parts of the blood, or 
of milk. 

Si-al'-o-gogues. Medicines that promote 
the flow of saliva. 

Sin f -a-pism. A mustard plaster. 

Sin'-ew (sin'-yu). That which unites a 
muscle to a bone. 

Slough'-ing (sluff'-ing). The separation 
of the dead flesh from a sore. 

Sol'-vent. Having the power to dissolve 
solid substances. 

Sor'-des. The dark matter deposited upon 
the lips and teeth in low fevers. 

Spasm. An involuntary contraction of the 
muscles. 

Spe-cif'-ic. An infallible remedy. 

Spleen. The milt ; it is situated in the abdo- 
men and attached to the stomach. 

Squa'-mous (squa'-mus). Scaly; having 
scales. 

Ster'-tor. Noisy breathing, as in apoplexy ; 
snoring. 

Ster'-to-rous. Snoring. 

Stool. A discharge from the bowels. 

Stran'-gn-ry. Difficult and painful expulsion 
of urine. 

Strict'-ure. Unnatural contraction of any 
passage of the body. 

Stru'-ma. Scrofula. 

Sub-cu-ta' -ne-ous. Under the skin. 

Sup-pos'-i-to-ries. Medicinal substances in- 
troduced into the rectum to favor or re- 
strain evacuations, or to ease pain. 

Sup-pn-ra'-tion. Forming of pus. 

Sii'-ture. The peculiar joint uniting the 
bones of the skull. 

Symp'-tom. A sign or token ; the peculiar 
marks of any disease. 



Syn / -o-cha. Inflammatory fever. 

Ten'-don. A fibrous cord attached to the ex- 
tremity of a muscle. 

Tc-nes'-mus. A painful bearing down sen- 
sation in the lower bowels. 

Tense, Tension. Rigid, hard, stiff; drawn 
tightly. 

Tep'-id. Warm, but not hot. 

Ter'-tian (ter'-shun). Occurring every 
other day. 

Tho'-rax. The cavity in the chest. 

Tinct'-ure. Medicine dissolved in alcohol. 

Tor-mi'-na. Severe griping pains. 

Tor'-pid. Dull, stupid. 

Tra'-che-a. The windpipe. 

Tu-me-fac'-tion. The act of swelling or 
forming a tumor. 

Tu'-mor. A distention or enlargement of 
any part of the body ; a swelling. 

Ul'-cer. A sore, discharging pus. 

Um-bil'-ic. The navel, or pertaining to the 
navel. 

U'-rea. A substance found in the urine. 

U-re'-ter. The duct or tube through which 
the urine passes from the kidneys to the 
bladder. 

U-re'-thra. The canal through which the 
urine passes from the body. 

U'-vu-la. The small conical body project- 
ing from the middle of the soft pal- 
ate. 

Vac'-ci-nate (vak'-si-nate). To inoculate 
with the cowpox by inserting the vaccine 
in the skin. 

Vac / -cine (vak'-sin). Belonging to, or mat- 
ter of, the cowpox. 

Va-gi r -na. The passage that connects the 
vulva with the womb. 

Val-e-tu-di-na'-ri-an. A person of a weak, 
infirm, or sickly constitution. 

Ve'-hi-cle (ve'-hi-kl). A liquor in which to 
administer medicines. 

Ve'-noas. Relating to the veins. 

Ves / -i-ca-ting. Blistering. 

Ves f -i-cle (ves'-i-kl). A little bladder of 
water formed under the skin. 

Vir'-u-lent. Extremely injurious ; malig- 
nant ; poisonous. 

Vi'-rus. Active, contagious matter. 

Vis'-ce-ra. The internal organs of the body. 

Vis f -cid. Glutinous ; sticky ; tenacious. 

Vit'-re-ous Hu'-mor. One of the fluids of 
the eye, resembling glass. 

VoV-a-tile. Easily evaporated ; substances 
that waste away on exposure to the at- 
mosphere. 

V ul' -ner-a-ry . Pertaining to wounds. 
Zy-mot f -ic. Contagious ; infectious ; such 
diseases as may be inoculated. 



836 USEFUL MEDICAL KNOWLEDGE. 

USEFUL HINTS AND INFORMATION. 
DOSES FOR CHILDREN. 



Brundage's Rule for a Child Less Than 
One Year Old. — Take the number of months 
that the child lacks of being one year old ; 
add 12 ; make that the denominator of a 
fraction whose numerator is 1. That will 
be the fraction of the adult dose to be given. 
Thus : a child of 6 months old lacks 6 months 
of being a year old; take 6, add 12; place 
the result, 18, in the fractional form of 1-18 ; 
and give the child 1-18 of the adult dose. 

General Methods for Children One Year 
or Over. — Take the age at the next birth- 
day, and divide this by 24. Give the frac- 
tional part of the adult dose. Thus : for a 
child over 5, give 6-24 of %. of the regular 



dose; for 11 years, give 12-24 or x / 2 . In 
giving aconite to young children to break 
up a fever, or to abort threatened at- 
tack, where minute doses are to be given, it 
is well to take about 10 drops in a half tum- 
blerful of water- and give a teaspoonful every 
20 minutes until perspiration is induced. 
Stop as soon as this occurs. This is a 'most 
satisfactory method of giving minute doses 
of strong medicines to young children. 

Dr. Young's Rule. — Divide the age of 
the child by the age plus 12. This gives the 
required fraction of the adult dose. Thus : 
for a child of 6, divide 6 by 6 + 12 = T 6 F or 
\ of the adult dose. 



URINE. 

Acid urine will turn blue litmus paper red. 
Alkaline urine will turn litmus paper blue. 

The normal specific gravity of urine, as 
shown by the urinometer, is from 1018 to 
1022; a high specific gravity indicates the 
presence of much solid matter. The average 
quantity passed in 24 hours is about 40 
ounces ov 2 J / 2 pints. 



The solids contained in healthy urine 
are : urea, uric acid, hippuric acid, creatinin, 
sodium chloride, phosphates and sulphates 
of sodium, potassium, magnesium, and cal- 
cium. The solids in diseased conditions are : 
albumen, sugar, pus, blood, acetone, diacetic 
acid, fat, chyle, casts, cells, epithelia, and 
bacteria. 



THERMOMETER. 



The standards most generally used are 
the Fahrenheit and the Centigrade. The 
Reaumur is used principally in Russia. ' In 
t\ie Fahrenheit scale, the boiling point 
of water is marked 212 degrees ; the freezing 
point is marked 32 degrees. The space be- 
tween these two is then marked off into 180 
equal spaces, each of which is a degree Fah- 
renheit. Thirty-two of these spaces below 
the freezing point marks the zero of this 
scale, or degrees. The temperature of the 
body on this scale is 92.4 degrees. 

The Centigrade thermometer is an ac- 
companiment of the metric system so gen- 
erally in use in European countries and by 
scientists the world over. The boiling point 
of water is marked 100 degrees Centigrade, 
and the freezing point, degrees Centigrade. 
The space between these points is then di- 
vided into 100 equal spaces, each of which is 
a degree Centigrade. 

Thus it will be seen that 100 degrees 
Centigrade are equal to 180 degrees Fahren- 



heit ; and a degree Fahrenheit is 100-180 or 
5-9 of a degree Centigrade ; a degree Centi- 
grade is 9-5 or- 1 4-5 degrees Fahrenheit. In 
converting degrees Fahrenheit into degrees 
Centigrade it must be remembered that the 
zero Fahrenheit is 32 degrees below the 
freezing point. 

To convert degrees Centigrade into de- 
grees Fahrenheit : Multiply the degrees 
Centigrade by 9 ; divide by 5 ; and add 32 de- 
grees. Thus : 40 degrees Centigrade = 
9X40 360 
X 32 = X 32 = 72 X 32 = 

5 5 

104 degrees Fahrenheit. 

To convert degrees Fahrenheit into de- 
grees Centigrade: Subtract 32 from the 
given number of degrees Fahrenheit ; multi- 
ply by 5 ; and divide by 9. Thus : 40 degrees 
5(40—32) 5X8 40 

Fahrenheit = = = — 

4 9 9 9 

= 4 — degrees Centigrade. 
9 



FACTS ABOUT MEDICINES. 

The action of medicine is modified by the 
condition of the individual, by the climate 
and season. 

In summer certain medicines act more 
vigorously than in winter, and the same per- 



he could in December. Persons of a phleg- 
matic temperament bear stimulants and pur- 
gatives better than those of a sanguine tem- 
perament, therefore the latter require smaller 
doses. Purgatives never act so well upon 



son may not bear the same dose in July that persons accustomed to take them as upon 



USEFUL HINTS. 



837 



those who are not, and in cases where purga- 
tives are necessary to be often used the form 
and kind should be changed occasionally. 

Purgatives should never be given when 
the bowels are in a state of irritation. Stim- 
ulants and narcotics never act as quickly 
upon persons accustomed to the use of stimu- 
lants. 

Medicine for females should not be so 
strong as for males. Reduce about one- 
eighth. 

Persons whose general health is good 
bear stronger doses than the debilitated and 
those who have suffered for a long time. • 

Castor oil may be taken in milk, coffee, 
or spirit, such as brandy ; but the best method 
of covering the nauseous flavor is to put 
a tablespoonful of strained orange juice in 
a wineglass, pour the castor oil into the cen- 
ter of the juice, and then squeeze a few drops 
of lemon juice upon the top of the oil. 

Cod-liver oil may be taken, like castor 
oil, in orange juice. 

Peppermint water almost prevents the 
nauseous taste of Epsom salts. 

A strong solution of extract of licorice 
covers the disagreeable taste of aloes ; milk 
that of cinchona bark; and cloves that of 
senna. 

An excellent way to prevent the taste of 
medicines is to have the medicine in a glass, 
as usual, and a tumbler of water by the side 
of it. Then take the medicine and retain it 
in the mouth, which should be kept closed, 
and if you then commence drinking the 
water, the taste of the medicine is washed 
away. - 

It is desirable to render medicines as 
palatable and pleasant as possible and to 
administer them at such times, and with 
such precautions, as shall render their re- 
tention and action most probable ; for adults, 
who can swallow pills, this is the easiest and 
best mode of taking such remedies as will 
go in a small compass. For children gen- 
erally they are unsuitable, and draughts or 
powders must be given to them, unless, as is 
now often the case, medicated cakes or loz- 
enges, containing the remedies which their 
cases require, can be procured. 

The best vehicle for children's powders 
which contain any heavy substance is sugar 
moistened just a little, or honey, or molasses, 
or gum ; it must be some thick substance or 
the powder will fall to the bottom, and so 
not be taken. Powders with rhubarb, mag- 



nesia, or any light substance may be mixed 
up thin and drunk ; a piece of sugar with a 
few drops of essence of peppermint on it, 
or a strong peppermint lozenge, will get rid 
of the unpleasant taste perhaps sooner than 
anything else; those who object to this 
should chew a piece of dried orange peel 
both before and after swallowing the medi- 
cine. Aperients are best taken on an empty 
stomach, so are vermifuges ; tonics should 
be taken an hour or so before meals, except 
preparations of iron, which are best an hour 
after meals ; emetics are commonly directed 
to be taken in the evening, because after 
their operation the patient may rest awhile. 
Stimulants of course may be taken at any 
time when required ; opiates always at bed- 
time, that their action may not be inter- 
rupted ; unless it be a case of spasm or vio- 
lent pain which calls for instant relief. Strong 
purgatives are best taken in the morning ; 
at night they would disturb the rest, and 
cause great inconvenience. All these, of 
course, are but general rules, to which there 
are numerous exceptions. The discreet 
mother or nurse will know when they are to 
be strictly followed, and when departed from. 

Condition of the Stomach. — The least 
active remedies operate violently on some 
persons, owing to a peculiarity of stomach 
or disposition of body unconnected with 
temperament. In giving medicines, the 
medical man always so regulates the inter- 
vals between doses that the following dose 
may be taken before the effect produced by 
the former is altogether effaced. By not 
attending to this rule, the cure is always com- 
mencing, but never rapidly proceeding — it 
may, indeed, have no effect at all. It is to 
be borne in mind, at the same time, that some 
medicines, such as mercury, etc., are apt to 
accumulate in the system, and danger may 
thence arise if the doses be repeated too 
frequently. Aloes and castor oil acquire 
greater activity by use, so that the dose re- 
quires to be diminished. With due caution, 
and a proper attention to the doses ordered, 
no untoward circumstance need arise. 

The condition of the mind has a powerful 
influence upon the disorders of the body. 
The effect of the imagination works wonders 
for or against recovery. Many of the ex- 
traordinary cures credited to traveling "medi- 
cine men," ''great remedies," etc., are noth- 
ing more than the influence of the imagina- 
tion over a disordered body or mind. 



APPROXIMATE MEASURES. 



For the convenience of those who have 
not accurate measures at hand, we give the 
approximate quantities : — 

A teacup contains four fluid ounces, or 
<?ne gill. 



A wineglass contains two fluid ounces. 

A tablespoon contains one-half fluid 
ounce. 

A teaspoon contains one-eighth fluid 
ounce, or one dram. 



8 3 8 



USEFUL MEDICAL KNOWLEDGE. 



Sixteen large tablespoonfuls make half a 
pint. 

Eight large tablespoonfuls make one gill. 



Four large tablespoonfuls make half gill. 
Sixty to eighty drops are equal to one 
teaspoonful. 



APOTHECARIES' WEIGHT. 



20 grains = 1 scruple = 20 grains. 
60 grains = 1 dram = 3 scruples. 

480 grains = 1 ounce = 8 drams. 

5,760 grains = 1 pound = 12 ounces. 

The scruple and dram are discarded in 
the new weights. Measures of capacity are 
used for liquids in mixing medicines. For- 
merly wine measure was employed, but now 
it is the imperial. The weight of the im- 
perial minim of water is 91 grains, and is 
multiplied as follows : — 

60 minims =. 1 fluid dram = 60 minims. 
480 minims = 1 fluid ounce = 8 fl. drains. 
9,600 minims = 1 pint = 20 fl. ozs. 

76,800 minims = 1 gallon = 8 pints. 

The fluid ounce is the measure of one ounce 
of water ; the pint, 1 % lbs. ; and the gallon, 
10 lbs. In prescriptions the weights and 
measures are generally expressed by signs or 
symbols, with Latin numerals affixed. These 
signs, with the Latin and English words 
which stand for them, are given below : — 

yyi Minim, l-60th part of a fluid 
drams. 
9 J Scrupulus, a scruple. 
5 J Drachma, a dram. 
I 3 J Fluid Drachma, a measured dram. 

§ j Uncia, an ounce (437.5 grains). 
I c5 j Fluid uncia, a measured ounce. 
ibj Libra, a pound (7,000 grains). 
Oj Octarius, a pint. 
gr Granum, a grain. 
SS Semis, half, affixed to any of the 
above signs. 

The numerals j, ij, iij. iv, v, etc., show 
the number of grains, ounces, pounds, etc., 
to be taken ; thus, mix denotes 60 minims, 
5 vii, 7 drams, and § j, 1 ounce. 

Teaspoonful. — Generally taken to mean 
1 fluid dram or % of an ounce ; but, in real- 
ity, it is 1-6 of an ounce or 1 1-3 drams. 



Dessert-spoonful. — About 2 fluid drams 
or J4 of an ounce. 

Table spoonful. — About 4 fluid drams or 
y 2 an ounce. 

Wineglass. — About 2 fluid ounces or % 
of a pint. 

Pint. — 16 fluid ounces, or 128 fluid 
drams, or 7680 minims. It is Y% of a gallon; 
28 7-8 cubic inches ; and .4732 of a litre 
(less than y 2 ). 

Minim. — 1-60 of a fluid dram. It is gen- 
erally taken to mean a drop. But this is not 
always true and in practice ought not to be 
followed. So much depends upon the con- 
sistency of the fluid ; as well as the vessel 
from which the medicine is dropped. If the 
solution is water or watery a drop poured 
from a bottle is from 1 to % minims. A drop 
of wine or very dilute alcohol is from 7-20 to 
1 minim ; of tinctures and spirits, from 2-5 
to 3-5 of a minim; of ether, 3-10 to 2-5 of a 
minim. If a medicine dropper is used no 
estimate can be made as the openings are by 
no means uniform in these articles. Where 
minims are prescribed care should be exer- 
cised in measuring them. 

Dram. — Y% of an ounce. A fluid dram 
is measured in a graduate. A dram (solid) 
is weighed. 

Ounce. — A fluid ounce is 1-16 of a pint. 
A solid ounce is 1-12 of a pound. 

Troy. — Or 1-16 of a pound avoirdupois. 
A Troy ounce is 31 grams. An Avoirdu- 
pois ounce is 28.35 grams. 

Grain. — There are 480 grains in a Troy 
ounce; and 437.5 grains in an Avoirdupois 
ounce. There are 5760 grains in a Troy 
pound and 700 grains in an Avoirdupois 
pound. A grain is 1-15 of a gram (the 
basis of the metric system of weight). 

Pound. — A pound of a liquid, as used by 
the druggist, is a pint. A pound Troy con- 
tains 12 ounces, or 96 drams, or 5760 grains. 
A pound Avoirdupois contains 16 ounces, or 
7000 grains. 



PROPER DOSES FOR DIFFERENT AGES. 



Ages. 
For an Adult 



Under 
Under 
Under 
Under 
Under 



i year 

2 years 

3 years 

4 years 
7 years 



Under 14 years 
Under 20 years 
Above 21 years 
Above 65 years 
Above 80 years 



Proportional Doses. 
Suppose the dose One 
"Will require only i-i2th 
Will require only i-8th 
Will require only i-6th 
Will require only T-4th 
"Will require only i-3d 
Will require only 1-2 
"Will require only 2-3ds 
The full dose One 
Will require only 3-4ths 
Will require only 2-3ds 



Dose. 
as 1 dram or 60 grains, 
as 5 grains, 
as 8 grains. 
as 10 grains, 
as 15 grains. 

as 1 scruple or 20 grains, 
as 1-2 dram or 30 grains, 
as 2 scruples or 40 grain, 
as 1 dram, 
as 45 grains, 
as 2 scruples or 40 grains. 



USEFUL HINTS. 



839 



In the same manner for fluids divide the 
quantity suited for an adult by the above 
fractional parts. If for a child under one 



year, the dose will be ona-twelfth ; under 
two years, one-eighth ; under three years, 
one-sixth, and so on. 



TO MAKE SOLUTIONS OF A GIVEN PER CENT FOR 
FOUR FLUID OUNCES. 



of 1 per cent, take 

of 1 per cent, take 2 

of 1 per cent, take 3 

of 1 per cent, take 4 

of 1 per cent, take 6 

of 1 per cent, take 9 

per cent, take 18J4 

per cent, take Z6 J / 2 

l / 2 per cent, take 45^ 

per cent, take 54^ 



f grain. 4 per cent, take 

34 grains. 5 per cent, take 

grains. 6 per cent, take 

l / 2 grains. 7 per cent, take 

grains. 8 per cent, take 

grains. 10 per cent, take 

grains. 12 per cent, take 

grains. 15 per cent, take 

grains. 20 per cent, take 

grains. 25 per cent, take 

Take 4 ounces of water in each case. 



1 dram, 12] 
1 V 2 drams. 



dram, 
drams, 
drams, 
drams, 
drams, 
drams, 33 
drams, 4 
drams, 35 



-2 grains. 

grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains. 



PULSE BEATS PER MINUTE. 



In the foetus (befo/e birth), 
The newborn, 
The first year, 
The second year, 
The third year, 



from 150 to 140. 
from 140 to 130. 
from 130 to 115. 
from 115 to 100. 
from 105 to 95. 



From seven to fourteen, from 90 to 80. 

From fourteen to twenty-one, from 85 to 75. 

From twenty-one to sixty, from 79 to 75. 

In old age, from 75 to 80. 



First year, 
Second year, 



RESPIRATIONS PER MINUTE. 



about 35. 
about 25. 



Puberty, 
Adult, 



about 20. 
about 18. 



THE CLINICAL THERMOMETER. 



A clinical thermometer does not differ 
essentially from the common weather ther- 
mometer ; it is smaller, more accurate, and is 
not supported in a frame. The figures are 
engraved on the glass, and are graduated 
from about 90 to 115 degrees. These ther- 
mometers are generally self-registering. At 
the top of the mercury there is a little piece 
which has purposely been left detached, to 
serve as an index. Before taking the tem- 
perature this is shaken down to about 96 
degrees ; then, as the mercury rises, the de- 
tached portion is left at the highest point 
reached. 

The normal temperature of the body is 
about 98.4 degrees. 

How to Take the Temperature. — There 
are three regions where the temperature 
may conveniently be taken : the bowel, the 
armpit, and under the tongue. In the case 
of children, where the knowledge of the 
temperature is always important, the bowel 
is the most convenient and generally more 
preferable. 

The following is the method of ascertain- 
ing the temperature under the armpit : the 
index should be shaken down, and the instru- 
ment warmed by holding in the closed hand 
for a moment. The patient, if lying on the 
side, should be turned over, and the observa- 



tion made in what was the lower armpit. 
The bulb of the instrument should be placed 
snugly within the folds of the armpit, care- 
fully observing that it is in contact with the 
skin on all sides, and that none of the 
garments interfere. The fore-arm of the 
patient should be laid across the chest ; while 
in this position, let the thermometer re- 
main five minutes. 

The temperature under the tongue is 
taken as follows : shake down the index and 
warm as before ; place the bulb of the instru- 
ment as far back under the tongue as pos- 
sible, close the mouth, and breathe through 
the nose for three minutes. 

The temperature in the bowel is taken as 
follows : shake down the bulb and warm 
instrument as above directed ; if the patient 
is an adult, he should lie on one side, with 
knees well drawn up ; if a child, let it be 
placed on its chest across its mother's knee, 
or its legs may simply be held up enough to 
expose the parts ; dip the instrument into 
sweet oil, and pass the bulb through the anus 
into the bowel for a space of about two 
inches, and let it remain three minutes. 

The instrument should be thoroughly 
cleansed with carbolic acid after each ob- 
servation and in cases of contagious dis- 
eases. 



INDEX. 



Abdominal breathing 755 

Abdominal ring 733 

Abductor minimi digiti muscle 736, 737 

Abductor pollicis muscles 737 

Abortion 485 

A. B. S. pill 812 

Abscess 444 

Abscess, Homeopathic treatment of 676 

Abscess, Peritonsilar 338 

Abscess, Peritonsilar, in children 547 

Abstinence from food 41 

Acacia 784 

Acacia, Mucilage of 807 

Acacia, Syrup of 819 

Accidents and emergencies 571 

Accommodation 769 

Acetabulum 724 

Acetanilid 784 

Acetanilid, Danger of using 660 

Acetanilid, Poisoning by 612 

Acetanilid powder, Compound 813 

Acetate of opium 784 

Acetate of squill 784 

Acetic acid 784 

Acetylene light 142 

Acids 784 

Acids, Burns with 598 

Acids, Poisoning by mineral 613 

Aconite 786 

Aconite, Fluidextract of 798 

Aconite, Poisoning by 613 

Aconite, Tincture of 821 

Adductor brevis pollicis muscle 737 

Adductor minimi digiti muscles 737 

Adductor pollicis muscle 736 

Adenoid growths 92 

Adeps 802 

Adhesive plaster 795 

Adjuvant elixir 795 

Aesculus pavia 635 

Afterpains 492 

Age a predisposing cause to disease 146 

Age and diet 35 

Air and ventilation 85 

Air, Impurities of 85, 137 

Air in sick room, To purify the 255 

Air of sewers, Diseases produced by 88 

Air passages 752 

Air, Testing the purity of the 87 

Airing in infancy 506 

Albinos 769 

Albumen, Definition of 30 

Albumen of the blood 752 

Albuminous food 29 

Alcohol 786 

Alcohol, Effects of 650 

Alcohol rub 253 

Alcoholism 646 

Alcoholism, Treatment of 650 



Alkalies, Burns with 598 

Alkaline water 707 

Allspice 812 

Allspice, Oil of 809 

Almond, Emulsion of 795 

Almond oil 786 

Almond, Syrup of 819 

Almonds as a food, Value of 32 

Almonds, Essence of bitter 817 

Almonds, Expressed oil of 808 

Almonds, Oil of bitter 808 

Aloes 786 

Aloes and mastic, Pills of 811 

Aloes and myrrh, Tincture of 821 

Aloes, Compound decoction of 794 

Aloes, Extract of 796 

Aloes, Pills of 811 

Aloes, Tincture of 821 

Aloin 787 

Alopecia 304 

Alopecia areata 306 

Alum 787 

Alum an emetic 612 

Alum, Glycerine of 800 

Alum in baking powder 39 

Alveoli 753 

Amanita muscaria 620 

Amenorrhea 463 

American laurel 639 

American water hemlock 636 

Ametropia 100 

Ammonia 787 

Ammonia gas 85 

Ammonia liniment, 787, 803 

Ammonia, Poisoning by 613 

Ammonia water 788 

Ammoniac 787 

Ammoniacum and mercury plaster 795 

Ammoniated mercury 801 

Ammonium acetate, Solution of 803 

Ammonium chloride, Troches of 823 

Ampulla 772 

Anaemia 439 

Anaemia, Cerebral 440 

Anaemia defined 752 

Anaemia, Homeopathic treatment of 676 

Anatomy 714 

Anchylosis 432 

Anconeus muscle 735 

Aneurism 417 

Aneurism detected by X-ray 701 

Aneurism, Diet in 278 

Anger 124 

Angina pectoris 359 

Angina pectoris, Homeopathic treatment 683 

Angle of lower jaw 716 

Anise 787 

Anise, Oil of 808 

Anise, Spirit of 817 



842 



INDEX. 



Anise water 788 

Ankle, Sprained 592 

Anthrax benigna 457 

Antibilious pills 811 

Antidotes for poisons 611 

Antimony 788 

Antimony, Poisoning by 613 

Antimony, Wine of 825 

Antipyrine 788 

Antipyrine, Poisoning by 613 

Antiseptic care 261 

Antiseptic solution 803 

Antitoxin 816 

Antitoxin, Action of 704 

Aorta 748 

Aorta, Arch of the 743 

Aperient 777 

Apocynum, Fluidextract of 798 

Apomorphine hydrochloride 788 

Apoplexy 417 

Apoplexy, Homeopathic treatment of 676 

Apothecaries' weight 805 

Apparatus denned 715 

Apparent death 606 

Appendicitis 384 

Appendicitis, Cold applications in 256 

Appendicitis, Early symptoms of 205 

Appetite, Defective, Homeopathic treatment 

of 678 
Apple of Peru 641 
Apples as food, Value of 32 
Apples, Roast 301 
Apricots as a food, Value of 32 
Aqua ammoniae 788 
Aqua ammoniae f ortior 788 
Aqua amygdalae amarae 788 
Aqua anisi 788 
Aqua aurantii florum 788 
Aqua aurantii florum fortior 788 
Aqua camphorae 788, 791 
Aqua chloroformi 788 
Aqua cinnamomi 788 
Aqua creosoti 788 
Aqua foeniculi 788 
Aqua hamamelidis 788 
Aqua hydrogenii dioxidi 788 
Aqua menthae piperitae 788 
Aqua menthae viridis 789 
Aqua rosae 789 
Aqua rosae fortior 789 
Aquae 788 

Aqueous humor 768 
Arachnoid 731 
Areolar tissue 727 
Argenti cyanidum 789 
Argenti nitras 789 
Argenti nitras fusus 789 
Argenti nitras mitigatus 789 
Argenti oxidum 789 
Arhythmia 357 
Arm and leg compared 723 
Arm, Fracture of the 590 
Arm, Muscles of the upper 735 
Arms, Bones of the 721 



Arms, Massage for the 277 

Arnica 789 

Arnica, Tincture of 821 

Aromatic elixir 794 

Aromatic fluidextract 798 

Aromatic powder 789, 813 

Aromatic spirit of ammonia 789 

Aromatic sulphuric acid 785 

Arsenate of soda 789 

Arseni trioxidum 789 

Arsenic, Poisoning by 613 

Arsenic trioxide 789 

Arsenous acid 789 

Arsenous acid, Solution of 803 

Arsenous anhydride 789 

Arsenous oxide 789 

Arteries 746 

Arthritis 430 

Articulations 719 

Artificial respiration 607 

Asafoetida 789 

Asafoetida, Emulsion of 795 

Asafoetida, Pills of 811 

Asafoetida, Tincture of 821 

Asiatic cholera 415 

Asiatic cholera, Homeopathic treatment of 

676 
Asphyxia of newborn child 496 
Aspidium 789 
Assimilation 757 
Asthma 345, 596 

Asthma, Homeopathic treatment of 676 
Asthma weed 645 
Astigmatism 100 
Astragalus 730 

Atlas or first cervical vertebra 720 
Atomizers, 93, 242 
Atropinae sulphas 790 
Atropine 789 

Atropine, Poisoning by 614 
Atropine sulphate 790 
Auditory canal, External 716 
Auditory nerve 772 
Aura epileptica 421 
Aurantii amari cortex 790 
Aurantii dulcis cortex 790 
Auricle of the heart 744 
Autumn sneezeweed 643 
Axis or second cervical vertebra 720 

Backbone 720 

Bacillus diphtheriae 151 

Bacillus tuberculosis 166 

Bacteria 150 

Bacteria, Action of, within the body 151 

Bacteria, effect on teeth 49 

Bacteria, existence outside of body 152 

Bacteria in drinking water 43 

Bacteria, mode of entrance into the body 151 

Bacteria, mode of exit from the body 152 

Bacteria, modes of transmission 152 

Bacteria of cholera 151 

Baking powder, How to examine 39 

Baldness 304 



INDEX. 



843 



Baldness, Homeopathic treatment of 677 

Balsam of fir 821 

Balsam of Peru 790 

Balsam of tolu 790 

Bandages 232, 576 

Bandages, Rubber 233 

Barberry 790 

Barber's itch 312 

Barber's itch, Homeopathic treatment of 677 

Barium salts, Poisoning by 614 

Barley as a food, Value of 32 

Basham's mixture 790, 804 

Basilar process 716 

Basilicon ointment 790, 792 

Bath, Brand's, for typhoid fever 231 

Bath, Cold 51 

Bath, Cold, Effects of 52 

Bath, Cold sponge 253 

Bath, Evaporation 253 

Bath, Extremely hot 257 

Bath, Hot 53 

Bath in bed 252 

Bath, Medicated 253 

Bath of newborn child 495 

Bath room accessories 55 

Bath room, The 136 

Bath, Russian 55 

Bath, Sea 52 

Bath, Shower 53 

Bath, Sick room 251 

Bath, Sitz 253 

Bath, Sponge 55, 253 

Bath thermometer 54 

Bath, To prepare a patient for the 252 

Bath, Turkish 53 

Bath, Vapor 253 

Bath, Warm 52 

Bath, Whisk broom 252 

Bathing in infancy 508 

Beans as a food, Value of 32 

Bearberry 825 

Beauty massage 272 

Beaver poison 636 

Bed, How to prepare the 226 

Bedpan 243 

Bedsores, Prevention and management of 228 

Beef as a food, Value of 32 

Beef, Peptonized 294 

Beef tea 293 

Belladonna 779 

Belladonna leaves 790 

Belladonna leaves, Extract of 796 

Belladonna leaves, Tincture of 821 

Belladonna liniment 803 

Belladonna ointment 824 

Belladonna plaster 795 

Belladonna, Poisoning by 614 

Belladonna root 790 

Belladonna root, Fluidextract of 798 

Benzaldehyde 790 

Benzoin 790 

Benzoin, Compound tincture of 821 

Benzoin, Tincture of 82i 

Benzosulphinide saccharine 790 



Berberis 790 

Berberis, Fluidextract of 798 

Bernheim school of hypnotism 712 

Betanaphthol 790 

Betula, Oil of 808 

Bichloride of mercury 801 

Bichloride of mercury, Poisoning by 615 

Biceps muscle 737 

Big ivy 639 

Big-leaved ivy 639 

Bile 761 

Bilious cholera 376 

Bilious colic 379 

Bilious fever, Homeopathic treatment of 677 

Birth, Premature 487 

Bismuth and ammonium citrate 790 

Bismuth citrate 790 

Bismuth oxide 790 

Bismuth subcarbonate 790 

Bismuth subgallate 790 

Bismuth subnitrate 791 

Bite of cat 601 

Bite of rat 601 

Bites of insects 598 

Bites of snakes 599 

Bitter apple 793 

Bitter orange peel 790 

Bitter orange peel, Fluidextract of 798 

Bittersweet 642 

Bittersweet nightshade 642 

Black cohosh 793 

Black draught 802 

Black haw 825 

Black nightshade 641 

Black snakeroot 793 

Blackberry 814 

Blackberry, Syrup of 820 

Blackheads 59, 452 

Bladder 765 

Bladder, Inflammation of the 398 

Bladder, Inflammation of the, Homeopathic 

treatment of 681 
Bladder, Sphincter of the 765 
Bladder, Stone in the, detected by X-ray 

701 
Blaud's pills 811 
Bleaching the hair 73 
Blear eye 315 

Bleeding from the lungs 585 
Bleeding from the lungs, Homeopathic 

treatment of 677 
Blepharitis 318 
Blistering cerate 792 
Blistering flies 791 
Blisters 237, 782 
Blood, Albumen of the 752 
Blood, Arterial 748 
Blood as a food, Value of 32 
Blood, Circulation of the 744 
Blood clot 752 
Blood, Coagulation of 752 
Blood, Corpuscles of the 751 
Blood, Fibrin of the 752 
Blood, Venous 756 



844 



INDEX. 



Blood poisoning, Means of preventing 157 

Bloodroot 644, 779, 815 

Bloodroot, Tincture of 823 

Blue mass 805 

Blue ointment 824 

Blue pill 805 

Body, Chemical composition of 30 

Body, Chemical elements composing the 717 

Body, Physical properties of the 717 

Body, Structure of the 717 

Boil 458 

Bones 719 

Bones, Care of the 106 

Bones, Chemical composition of 721 

Bones, Diseases of the 108 

Bones, Flat 723 

Bones, Growth of 721 

Bones in old age 108 

Bones, Irregular 723 

Bones, Long 723 

Bones, Metacarpal 726 

Bones, Metatarsal 730 

Bones, Nourishment of 721 

Bones of the arm 721 

Bones of the ear 771 

Bones of the face 725 

Bones of the feet, Malformation of the 107 

Bones of the fingers 726 

Bones of the foot 730 

Bones of the hand 726 

Bones of the head 725 

Bones of the legs 721 

Bones, phalanges of the fingers 726 

Bones, Shape of 723 

Bones, Short 723 

Bones, Structure of 721 

Bones, Ulceration of the, Homeopathic 
treatment 686 

Boneset 796 

Borax 816 

Borax, Glycerine of 800 

Boric acid ointment 824 

Boroglycerine, Glycerite of 800 

Bowel, Falling of the 382 

Bowel, Falling of the, Homeopathic treat- 
ment 684 

Bowel, Obstruction of the 383 

Bowels, Diseases of the 370 

Bowels, Inflammation of the, Homeopathic 
treatment 676 

Bowlegs 107, 530 

Boxing a child's ears 96 

Brachialis anticus muscle 737 

Brachycardia 359 

Braid, Dr. James 712 

Brain, The 731 

Brain, Congestion of the 441 

Brain, Congestion of the, Homeopathic treat- 
ment of the 677 

Brain, Concussion of the 423 

Brain, Concussion of the, Homeopathic treat- 
ment of the 677 

Brain, Convolutions of the 740 

Brain examined by X-ray 700 



Brain fever 425 

Brain, Gray matter of the 740 

Brain, Inflammation of the 423 

Brain, Inflammation of the outer covering 

of the 424 
Brain in old age 731 
Brain, Size of, in lower animals 731 
Brain, White matter of the 740 
Bran bread for diabetics 299 
Branch ivy 639 

Brand's bath for typhoid fever 231 
Brandy 818 

Bread as a food, Value of 32 
Bread for diabetics 298 
Bread poultices 240 
Breakbone fever 400 
Breastfeeding 511 
Breast, Inflammation of the 490 
Breastbone 718 
Breasts, Care of 476 
Breasts, Care of, during nursing 513 
Breasts of infants, Inflammation of 499 
Breath, Fetid, Homeopathic treatment of 

680 
Breathe properly, How to 89 
Breathing, Facts concerning 89 
Breathing through the nose 79 
Breathing through the skin 51 
Bright's disease, Acute 391 
Bright's disease, Chronic 392 
Bright's disease, Diet in 284 
Broad-leaf laurel 638 
Bromoform 791 
Bronchi 741 
Bronchial tubes 741 
Bronchitis, Acute catarrhal 340 
Bronchitis, Chronic 342 
Bronchitis, Homeopathic treatment 677 
Broom 815 
Brow ache 309 
Brow ague 309 
Brown mixture 806 
Bruise, To prevent discoloration 272 
Bruises, Massage for 272 
Brundage's rule of doses for children 803 
Buccinator muscle 732 
Buchu 791 

Buchu, Fluidextract of 798 
Buckeye, Poisoning by 635 
Buckthorn 799 
Bullets located by X-ray 702 
Burdock root 802 
Burnett's disinfecting fluid 804 
Burns 597 

Burns with acids 598 
Burns with alkalies 598 
Butter, How to detect artificial 38 

Cabbage as food, Value of 32 
Cacao butter 810 
Cade, Oil of 808 
Caffeine 791 
Caffeine citrate 791 
Cajuput, Oil of 808 



INDEX. 



845 



Calabar bean 811 
Calamus 791 

Calamus, Fluidextract of 798 
Calcareous waters 707 
Calcium 759 
Calcium chloride 791 
Calcium hydroxide, Solution of 803 
Calcium lactophosphate, Syrup of 819 
Calculi detected by X-ray 701 
Calculi, Renal 396 
Calendula, Tincture of 821 
Calico bush 639 
Calomel 801 
Calumba 791 

Calumba, Fluidextract of 798 
Calumba, Tincture of 821 
Camphor 791 
Camphor cerate 792 
Camphor liniment 803 
Camphor, Spirit of 818 
Camphor water 791 
Camphorated oil 803 
Canada balsam 821 
Canadian hemp 788 
Canal of Petit 769 
Canaliculi 721 
Cancer of the liver 388 
Cancer of the stomach 369 
Cancer of the womb 468 
Canker 543 

Canker of the mouth, Homeopathic treat- 
ment 677 
Cannabis, Extract of Indian 796 
Cannabis, Fluidextract of Indian 798 
Canned goods, To avoid impure 40 
Cantharides 237, 782 
Cantharides cerate 792 
Cantharides, Poisoning by 614 
Cantharides, Tincture of 821 
Cantharis 791 
Capillaries 750 
Capsicum 791 

Capsicum, Fluidextract of 798 
Capsicum plaster 795 
Capsicum, Tincture of 821 
Capsular ligament 730 
Capsule of Glisson 760 
Caraway 791 
Caraway, Oil of 808 
Carbolic acid 810 
Carbolic acid a disinfectant 161 
Carbolic acid, Glycerite of 800 
Carbolic acid ointment 825 
Carbolic acid, Poisoning by 613 
Carbo ligni 792 
Carbon dioxide 85 
Carbon dioxide, Fatal effects of 86 
Carbon monoxide 138 
Carbon monoxide, Effects of 86 
Carbonaceous food 30 
Carbonic acid gas 85 
Carbonic acid gas, Fatal effects of 86 
Carbonic acid gas, Test for presence of 86 
Carbonic acid water 707 



Carbuncle 457 

Cardamom 791 

Cardamom, Compound tincture of 822 

Cardamom, Tincture of 821 

Cardiac depressant 779 

Cardiac dilation of the stomach 757 

Cardiac orifice of the stomach 757 

Cardiac period 746 

Cardiac stimulant 779 

Carditis 356 

Carlsbad water, Analysis of 708 

Carminatives 779 

Carolina jasmine 639 

Carolina wild woodbine 639 

Carotid canal 716 

Carron oil 803 

Carrots as food, Value of 32 

Carrying injured persons 571 

Cartilage 719 

Cascara sagrada 814 

Cascara sagrada, Extract of 797 

Cascara sagrada, Fluidextract of 799 

Casein 30 

Cashes 637 

Cassia, Oil of 808 ' 

Cassia, Purging 791 

Castor oil 809 

Cat, Bites of 601 

Cat scratches 601 

Catamenia 462 

Cataplasms 239 

Cataracts 318 

Catarrh, Chronic nasal 328 

Catarrh, Chronic, Homeopathic treatment 

677 
Catechu, Pale 800 
Cathartics 779 

Causes of disease. Mechanical exciting 148 
Caustic potash 812 
Caustic soda 817 
Caustics 780 
Cayenne pepper 791 
Cayenne plaster 237 
Cell body 715 
Cell nucleus 715 
Cellar walls 129 
Cementum of teeth 48 
Cerates 791 
Cerebellum 740 
Cerebral anaemia 440 
Cerebral fever 425 
Cerebral hemorrhage 417 
Cerebro-spinal fever 559 
Cerebro-spinal meningitis 559 
Cerebrum 740 
Cerium oxalate 792 
Cetaceum 792 
Chalazion 317 
Chalk mixture 806 
Chalk powder, Compound 813 
Chalk, Prepared 792 
Chalybeate waters 707 
Chamomile, German 806 
Chapin dipper 521 



8 4 6 



INDEX. 



Chapped lips, Homeopathic treatment 677 
Chapped skin, Cream for 58 
Charcoal 792 
Charcoal poultice 792 
Charcot school of hypnotism 712 
Chart. How to keep a 244 
Charta sinapis 792 
Cheek bone 718 
Cherries as food, Value of 32 
Chest breathing 755 
Chest, Cold in the 340 
Chest developed by right breathing 90 
Chest expansion 91 
Chest, Flat 82 
Chest, Massage for the 276 
Chicken as a food, Value of 32 
Chicken broth 294 
Chicken pox 570 

Chicken pox caused by impure air 86 
Chicken pox, Homeopathic treatment 677 
Chicken pox, Means of preventing 154 
Chicken tea 294 
Chilblains 448 
Child crowing 558 
Child, Diseases of newborn 496 
Child, First bath of the 495 
Child, Newborn, Care of 495 
Child to nurse, Training a 513 
Childbed fever 494 
Children, Care of 495 

Children, Diseases caused by improper feed- 
ing 529 
Children, Doses for 803 
Children, Feeding of 511 
Children, Hardening 64 
Children, Infectious diseases of 559 
Children's bane 636 
Chimaphila 792 

Chimaphila. Fluidextract of 798 
Chirata, Fluidextract of 798 
Chloral hydrate 792 
Chloral, Poisoning by 614 
Chloride of lime a disinfectant 162 
Chlorinated soda, Solution of 804 
Chlorine a disinfectant 162 
Chlorine, Compound solution of 804 
Chlorine water 804 
Chloroform 792 
Chloroform, Emulsion of 795 
Chloroform liniment 803 
Chloroform, Poisoning by 614 
Chloroform, Spirit of 818 
Chlorosis 439 

Choke damp, Poisoning by 614 
Choking 600 
Cholagogue 780 
Cholagogue cathartic 780 
Cholera, Asiatic 415 

Cholera, Asiatic, Homeopathic treatment 676 
Cholera, Bacteria of 151 
Cholera infantum 553 
Cholera. Means of preventing 156 
Cholera morbus, Homeopathic treatment 677 
Chorea, Homeopathic treatment 685 



Choroid coat of eye 767 

Chromic acid 782 

Chrysarobin 793 

Chrysarobin ointment 824 

Chyme 757 

Cicuta maculata 636 

Cicuta vagans 636 

Cigarettes 656 

Cilia 753 

Cilia of eyelashes 770 

Ciliary muscle 769 

Ciliary processes 768 

Cimicifuga 793 

Cimicifuga, Extract of 796 

Cimicifuga, Fluidextract of 798 

Cimicifuga, Tincture of 822 

Cinchona 793 

Cinchona, Compound tincture of 822 

Cinchona. Fluidextract of 798 

Cinchona, Tincture of 822 

Cinnamon 793 

Cinnamon, Oil of 80S 

Cinnamon. Spirit of 818 

Cinnamon, Tincture of 822 

Citric acid, Syrup of 819 

Citrine ointment 824 

Clavicle or collar bone 720 

Cleanliness in a house 135 

Cleanliness in nursing 254 

Cleft palate 533 

Climate and diet 34 

Clinical thermometer 806 

Cloves. Oil of 808 

Cloves. Synthetic oil of 796 

Closet, Dry earth 131 

Clothes catching fire 597 

Clothing 61 

Clothing in infancy 507 

Clothing, Tight waist 65 

Clothing, Too much 65 

Coal gas, Poisoning by 614 

Coal-tar products, Dangers of using 404 

Coca 793 

Coca, Fluidextract of 798 

Coca, Wine of 825 

Cocaine 793 

Cocaine frauds 661 

Cocaine, Poisoning by 614 

Coccaceae 151 

Coccus 793 

Coccyx 719, 724 

Cochineal 793 

Cochlea 772 

Codeine 793 

Codeine, Poisoning by 614 

Codfish as a food, Value of 32 

Cod-liver oil 809 

Cod-liver oil, Emulsion of 795 

Cod-liver oil with hypophosphites, Emulsion 

of 795 
Coffee. How to detect impurities in 37 
Cohosh, Black 793 
Colchicine 793 
Colchicum 793 



INDEX. 



847 



Colchicum conn, Extract of 796 

Colchicum, Poisoning by 614 

Colchicum seeds, Fluidextract of 798 

Colchicum seeds, Tincture of 822 

Colchicum seeds, Wine of 825 

Cold applications 256 

Cold bath 51 

Cold in the chest 340 

Cold in the ear 94 

Cold in the head 92, 327, 558 

Cold in the head, Homeopathic treatment 685 

Cold pack 230 

Cold, Protection against 77 

Cold sore 332 

Cold water applications 79 

Colic 378 

Colic, Bilious 379 

Colic, Homeopathic treatment 677 

Colic, Emergency treatment 595 

Colic of children 549 

Colic, Painter's 378 

Colic, Wind 379 

Collarbone 720 

Collar bone, Fracture of the 591 

Collodion 793 

Colocynth 793 

Colocynth, Compound extract of 796 

Colocynth, Extract of 796 

Colon 759 

Colostrum 496 

Coltsfoot 783 

Comma bacillus 151 

Complexion, The 56 

Compound cathartic pills 811 

Compound decoction of aloes 794 

Compound extract of colocynth 796 

Compound extract of sarsaparilla 799 

Compound laxative pills 811 

Compound pills of rhubarb 812 

Compound rosin cerate 792 

Concentrated foods, Value of 41 

Concussion of the brain 423 

Concussion of the brain, Homeopathic treat- 
ment 677 

Condyle 716 

Confection of rose 793 

Confection of senna 793 

Confection of sulphur 794 

Confections 793 

Confinement 487 

Congestion of the brain, Homeopathic treat- 
ment 677 

Congress water, Analysis of 708 

Conium 794 

Conium, Fluidextract of 798 

Conium maculatum 637 

Conium, Poisoning by 615 

Conjunctiva 767 

Conjunctivitis 316 

Constipation 370 

Constipation after delivery 492 

Constipation, Diet in 282, 370 

Constipation during pregnancy 481 

Constipation, Homeopathic treatment 677 



Constipation relieved by exercise 1 12 

Constitution and diet 40 

Constrictor muscle of pharynx 732 

Consumption 351 

Consumption, Clothing 184 

Consumption, Cure of 178 

Consumption detected by X-ray 701 

Consumption, Diet in 181, 287 

Consumption, Early symptoms of 173 

Consumption, Exercise in 182 

Consumption, how prevented 171 

Consumption, how spread 167 

Consumption, Modern methods of prevent- 
ing and curing 165 

Consumption, Outdoor life in 183 

Consumption, Ravages of 166 

Consumption, Shelter 183 

Consumption, Sleeping out of doors 186 

Consumption, What it is 166 

Contagia, Nature of 150 

Contagion 149 

Contrecoup 604 

Convalescence 265 

Convallaria 794 

Convallaria, Fluidextract of 798 

Convolutions of the brain 731 

Convulsions 559 

Convulsions, Emergency treatment 595 

Convulsions, Homeopathic treatment 677 

Convulsions, Hysterical, Homeopathic treat- 
ment 680 

Cooking, Importance of 41 

Coordination defined 427, 756 

Copaiba 794 

Copaiba, Oil of 808 

Copperas 797 

Copper sulphate 794 

Copper sulphate, Poisoning by 615 

Coriander 794 

Coriander, Oil of 808 

Cornea 767 

Corn silk 826 

Corns 446, 764 

Corpuscles, Red blood 751 

Corpuscles, White 751 

Corrosive sublimate 801 

Corrosive sublimate a disinfectant 160 

Corrosive sublimate, Poisoning by 615 

Coryza 327 

Cosmetic lotion 452 

Costal cartilages 718 

Costal respiration 755 

Costiveness, Homeopathic treatment 677 

Cottonseed oil 80^ 

Cotyloid notch 724 

Couch grass 823 

Cough during pregnancy 482 

Cough, Homeopathic treatment 677 

Coughs 195 

Counter-irritation 236 

Counterstroke 604 

Cowbane 636 

Cowper's glands 766 

Cow's milk 518 



8 4 8 



INDEX. 



Cow's milk, Modification of 518 

Coxalgia, Homeopathic treatment 680 

Cramp, Homeopathic treatment 678 

Cramp of the legs, Homeopathic treatment 
678 

Cramp of the stomach 365 

Cramp of the stomach, Homeopathic treat- 
ment 678 

Cramp-bark 825 

Cranesbill 800 

Cream, Whipped 292 

Cream of tartar 812 

Creatinin 803 

Creosote 794 

Creosote, Poisoning by 615 

Crepitation defined 702 

Cresol, Compound solution of 804 

Creta preparata 792 

Crotonoil 810 

Croton oil, Poisoning by 615 

Croup 555 

Croup, Emergency treatment 596 

Croup, Homeopathic treatment 678 

Crucial incision 458 

Crystalline lens 768 

Cubeb, Fluidextract of 798 

Cubeb, Oil of 808 

Cubeb, Troches of 823 

Cuboid bone 730 

Cucumbers as food, Value of 32 

Culver's root 803 

Culver's root, Extract of 797 

Cuneiform bone 726 

Cuneiform bones of the foot 730 

Cupping 238 

Cupri sulphas 794 

Custard, Soft 300 

Cuticle, 50, 762 

Cyanide of potash, Poisoning by 615 

Cypripedium, Fluidextract of 798 

Cystitis 398 

Cystitis, Homeopathic treatment 681 

Dandelion 821 

Dandruff 67, 303 

Dandruff, Lotion for 68 

Dandruff, Shampoo for 67 

Dandruff, To prevent 68 

Dandruff, Treatment of 303 

Dandy fever 400 

Datura stramonium 640 

Datura tatula 641 

Deadly amanita, Poisoning by 620 

Deadly nightshade 641 

Deafness 95 

Deafness in children 96 

Death, Apparent, of newborn child 496 

Death of man 636 

Debility, Diet in 284 

Decoctions 794 

Decoction of aloes, Compound 794 

Decoction of logwood 794 

Decoction of pomegranate bark 794 

Deformities, Exercises for preventing 82 



Delicate children, Care of 503 

Delirium in fevers 258 

Delirium tremens 652 

Deltoid muscle 732, 735 

Demulcents 780 

Dengue 400 

Dental sacs 774 

Dentine of teeth 48 

Dentition 774 

Deodorants 780 

Dermis 762 

Despondency during pregnancy 483 

Desserts 301 

Detergents 780 

Development of infants 508 

Devil's apple 641 

Diabetes, Diet in 283 

Diabetes, Homeopathic treatment 678 

Diabetes insipidus 389 

Diabetes mellitus 390 

Diabetes mellitus, Homeopathic treatment 
678 

Diabetics, Almond bread for 298 

Diabetics, Bran bread for 299 

Diachylon ointment 824 

Diachylon plaster 795 

Diaphoretics 780, 784 

Diaphragm 755 

Diarrhoea 372 

Diarrhoea, Diet in 282 

Diarrhoea, Emergency treatment 596 

Diarrhoea, Homeopathic treatment 678 

Diarrhoea of children 552 

Diet after labor 493 

Diet and change of conditions 35 

Diet and constitution 40 

Diet, arranged to suit constitution and tem- 
perament 40 

Diet, Arranging a 34 

Diet during pregnancy 475 

Diet during the third year 526 

Diet, Fever 278 

Diet for a child of fifteen months 525 

Diet for a child one year old 525 

Diet for a child of two years 526 

Diet for the sick 278 

Diet for those of bilious temperament 40 

Diet for those of lymphatic temperament 40 

Diet for those of nervous temperament 41 

Diet for those of sanguine temperament 40 

Diet, General principles of 30 

Diet governed by age 35 

Diet governed by climate 34 

Diet governed by occupation 35 

Diet in Bright's disease 284 

Diet in constipation 282 

Diet in consumption 287 

Diet in debility 284 

Diet in diabetes 283 

Diet in diarrhoea 282 

Diet in dyspepsia 281 

Diet in fever 281 

Diet in fevers 259 

Diet in gout 286 



INDEX. 



849 



Diet in liver troubles 283 

Diet in obesity 285 

Diet in rheumatism 286 

Diet, Need of a well balanced 31 

Diet, Subsistence 278 

Digestibility of food 32 

Digestive apparatus, Care of 26 

Digitalis 794 

Digitalis, Extract of 796 

Digitalis, Fluidextract of 798 

Digitalis, Infusion of 802 

Digitalis, Poisoning by 615 

Digitalis, Tincture of 822 

Dilatation of the heart, Homeopathic treat- 
ment 678 

Diphtheria 567 

Diphtheria antitoxin 816 

Diphtheria, Bacteria of 151 

Diphtheria, Early symptoms of 205 

Diphtheria, Homeopathic treatment 678 

Diphtheria, Means of preventing 155 

Diphtheria spread by impure air 86 

Diphtheria, Use of antitoxin in 703 

Disassimilation 757 

Disease, Causation and prevention of 145 

Disease, Chemical exciting causes to 149 

Disease, Definition of 25 

Disease, Detection of 187 

Disease, Exciting causes of 148 

Disease, Mechanical exciting causes of 148 

Diseases of adults, Local 303 

Diseases of children 529 

Diseases of the eyes 313 

Diseases of the head 303 

Diseases of women, Osteopathic treatment 
693 

Disease, Physical exciting causes to 149 

Disease, Predisposing causes of 146 

Diseases, Symptoms of common 203 

Disease, Vital exciting causes of 149 

Disease, Warnings of 189 

Disenfectants, 781 

Disinfectants, Chemical 160 

Disinfectants, Physical 158 

Disinfection 158 

Disinfection of clothing and bedding 164 

Disinfection of discharges from mouth and 
nose 163 

Disinfection of discharges through the skin 
163 

Disinfection of rooms and furniture 164 

Disinfection, Practical 163 

Dislocation of the elbow 593 

Dislocation of the fingers 594 

Dislocation of the lower jaw 593 

Dislocation of the shoulder 594 

Dislocation of the thumb 594 

Diuretics 781 

Dizziness 442 

Dizziness, Homeopathic treatment 679 

Dog, Signs of madness in a 403 

Donovan's solution 803 

Dover's powder 813 

Douches 93 



Dress during pregnancy 476 

Drinking water 42 

Dropsy, Homeopathic treatment 679 

Dropsy of the pleura 344 

Dropsy, Symptoms of 202 

Drowning, Apparent death from 606 

Drug frauds 659 

Drugs 775 

Drugs, Classification of 776 

Drugs of animal origin 776 

Drugs of mineral origin 775 

Drugs of vegetable origin 775 

Drugs, Physiological effects of 776 

Drugs, Sources of 775 

Duodenum 759 

Dura mater 731 

Dust an impurity of the air 86 

Dust, Effects of breathing 86 

Dust, Prevention of 134 

Dyed food, How to detect 37 

Dyes, Poisoning by 616 

Dysentery 375 

Dysentery, Emergency treatment 596 

Dysentery, Homeopathic treatment 679 

Dysentery, Means of preventing 156 

Dysmenorrhea 466 

Dysmenorrhea, Homeopathic treatment of 

683 
Dyspepsia 365 
Dyspepsia, Diet in 281 
Dyspepsia, Homeopathic treatment 679 

Ear 770 

Ear, Abscess in the 445 

Ear, Bones of the 771 

Ear, Boxing a child's 96 

Ear, Care of the 94 

Ear, Cold in the 94 

Ear, Diseases of the 322 

Ear, Eczema of the 324 

Ear, External 770 

Ear, Foreign bodies in the 96, 325 

Ear, Inflammation of the 323 

Ear, Inflammation of the, Homeopathic treat- 
ment 681 

Ear, Insects in the 96 

Ea\, Internal 772 

Ear, Middle 770 

Ear, Noises in the 95, 327 

Ear, Noises in the, Homeopathic treatment 
684 

Ear, Polypus of the 326 

Ear, Running of the, Homeopathic treatment 
684 

Ear trumpet 98 

Ear, Wax in the 95, 325, 771 

Earache 320, 596 

Earache during teething 323 

Earache, Homeopathic treatment 679 

Eardrum 770 

Eardrums, Artificial 98 

Eating before retiring 28 

Eating, Moderation in 28 

Eating, Rapid 27 



850 



INDEX. 



Eating too heartily 28 

Ecbolics 781 

Eczema 455 

Eczema, Homeopathic treatment 683 

Eczema of the ear 324 

Eggnog 299 

Eggs as food, Value of 32 

Eggs, Poached 300 

Eggs, Soft boiled 300 

Elaterin Trituration of 823 

Elaterinum 794 

Elaterium, Poisoning by 615 

Elbow, Dislocation of the 593 

Electric light, Incandescent 142 

Electric light, Largest known 711 

Electricity, Faradic 709 

Electricity, Galvanic 709 

Electricity, Voltaic 709 

Electrotherapy 709 

Electrotherapy, Facial paralysis 709 

Electrotherapy in hysteria 710 

Electrotherapy, Infantile spinal paralysis 710 

Electrotherapy, Locomotor ataxia 710 

Electrotherapy, Multiple neuritis 709 

Electrotherapy, Nervous prostration 710 

Electrotherapy, Neurasthenia 710 

Electrotherapy, Neuritis 710 

Electrotherapy, Paralysis agitans 710 

Electrotherapy, Shaking palsy 710 

Elixir, Adjuvant 795 

Elixir, Aromatic 794 

Elixir of iron, quinine, and strychnine phos- 
phates 795 

Elixir, Simple 794 

Elixirs 794 

Elm, Mucilage of 807 

Embolism 417 

Embrocations 241 

Emergencies, Domestic 595 

Emetic herb 645 

Emetics 781 

Emetics, List of 612 

Emmenagogues 782 

Emmetropia 100 

Emollients 780 

Emplastra or plasters 795 

Emulsion of almond 795 

Emulsion of asafcetida 795 

Emulsion of chloroform 795 

Emulsion of cod-liver oil 795 

Emulsion of cod-liver oil with hypophos- 
phites 795 

Emulsion of oil of turpentine 795 

Emulsions 795 

Enamel of teeth 48 

Endermic medication 242 

Endocarditis 356 

Enemata 234 

Energy, A stock of 125 

Enteric fever 410 

Enteritis, Homeopathic treatment 676 

Epidermis 762 

Epididymis 766 

Epiglottis 741 



Epilepsy 420 

Epilepsy, Homeopathic treatment 679 

Epispastics 782 

Epistaxis 330 

Epistaxis, Homeopathic treatment 677 

Epsom salt 805 

Ergot 795 

Ergot, Extract of 796 

Ergot, Fluidextract of 798 

Ergot, Poisoning by 615 

Ergot, Wine of 825 

Erigeron, Oil of 808 

Eriodictyon, Fluidextract of 798 

Eruption of disease 151 

Erysipelas 401 

Erysipelas, Homeopathic treatment 679 

Erysipelas, Means of preventing 157 

Erysipelas of newborn child 499 

Erythema, Homeopathic treatment 681 

Escharotic 780 

Ether 795 

Ether, Compound spirit of 817 

Ether, Poisoning by 615 

Ether, Spirit of 817 

Ethereal oil 808 

Ethyl chloride 796 

Eucalyptol 796 

Eucalyptus 796 

Eucalyptus, Fluidextract of 798 

Eucalyptus, Oil of 808 

Eugenol 796 

Euonymin 796 

Euonymus 796 

Euonymus, Extract of 796 

Euonymus, Fluidextract of 798 

Eupatorium 796 

Eupatorium, Fluidextract of 798 

Eustachian tube 95, 771 

Eustachian valve 743 

Evacuant pills 812 

Evening trumpet flower 639 

Exercise 109 

Exercise, Abdominal 119 

Exercise aids the skin 111 

Exercise and digestion 112 

Exercise and food 65 

Exercise, Arm and body 119 

Exercise, Bending and stretching 117 

Exercise, Bending th^ body 118 

Exercise, Bending the body sideways 118 

Exercise, Bending the body sideways and 

back 118 
Exercise benefits the nervous system 111 
Exercise, Bicycling 121 
Exercise, Development of the calf 119 
Exercise during pregnancy 476 
Exercise, Form of 113 
Exercise, Going upstairs 119 
Exercise improves the circulation 110 
Exercise improves the lungs 110 
Exercise in infancy 507 
Exercise, Physical 82 
Exercise, Physical, for young people 116 
Exercise, Quantity to be taken 113 



INDEX. 



851 



Exercise, Rotating the body 118 

Exercise, Rules while taking 117 

Exercise, Running a form of 116 

Exercise, Special value of 110 

Exercise, Walking a form of 114 

Exhaustion, Homeopathic treatment 679 

Expectorants 782 

Extensor brevis digitorum muscle 736 

Extensor carpi radialis brevior muscle 737 

Extensor carpi radialis longior muscle 737 

Extensor longus digitorum muscle 736 

Extensor ossis metacarpi pollicis muscle 737 

External oblique muscle 733 

Extracts 796 

Eye 767 

Eye, Black 319 

Eye, Blear 315 

Eye bruises 319 

Eye, Coats of the 767 

Eye, Gonorrhceal inflammation of the 317 

Eye, Inflammation of the, Homeopathic treat- 
ment 681 

Eye-strain 104 

Eye, Tests for the 101 

Eye, Watery 315 

Eye, White of the 767 

Eyeball, Protrusion of the 320 

Eyeball, Sinking of the 320 

Eyebrows 770 

Eyelids 770 

Eyelids, Inflammation of the edges of the 
318 

Eyes, Affections of the, Homeopathic treat- 
ment 679 

Eyes, Bathing the 105 

Eyes, Care of children's 99 

Eyes, Care of the 99 

Eyes, Diseases of the 313 

Eyes during convalescence, Care of the 103 

Eyes, Foreign bodies in the 105 

Eyes, Hypermetropic 769 

Eyes, Myopic 769 

Eyes, Need of resting the 105 

Eyes of newborn, Sore 500 

Eyes, Protection of the 102 

Eyes, Watery, Homeopathic treatment 686 

Eyes, Weakness of the 316 

Face, Bones of the 725 

Face brush 56 

Face cloths 56 

Face, To massage the 274 

Facial paralysis, Electrical treatment 709 

Fainting 361 

Fainting, Homeopathic treatment 679 

Falling of the womb, Homeopathic treatment 

679 
Fallopian tubes 766 
False jessamine 639 
False orange amanita, Poisoning by 620 
False sunflower 643 
Faradism 709 
Farcy 408 
Far-sightedness 100, 769 



Fasciculus 727 
Fats 30 

Fats, Composition of 717 
Fauces, 742 
Feeding, Breast 511 

Feeding, Diseases caused by improper 529 
Feeding during the first year, Time of 513 
Feeding, Mixed 512 
Feeding of children 511 
Feet, Excessive perspiration of 62 
Felbovis 797 
Fel bovis purificatum 797 
Felons, Homeopathic treatment 679 
Femur 728 
Fennel 797 
Fennel, Oil of 808 
Fennel water 788 
Fern, Male 789 
Ferri carbonas saccharata 797 
Ferri chloridum 797 
Ferri citras 797 
Ferri et ammonii citras 797 
Ferri et ammonii sulphas 797 
Ferri et ammonii tartras 797 
Ferri et potassii tartras 797 
Ferri et quininse citras 797 
Ferri et strychninse citras 797 
Ferri hydroxidum 797 
Ferri hypophosphis 797 
Ferri pyrophosphas solubilis 797 
Ferri sulphas 797 
Ferric ammonium sulphate 797 
Ferric chloride 797 
Ferric chloride, Solution of 804 
Ferric chloride, Tincture of 822 
Ferric citrate 797 
Ferric hydroxide 797 
Ferric subsulphate, Solution of 804 
Ferric sulphate, Solution of 804 
Ferrous carbonate, Mass of 805 
Ferrous carbonate, Pills of 811 
Ferrous iodide, Pills of 811 
Ferrous iodide, Syrup of 819 
Ferrous sulphate 797 
Ferrum reductum 797 
Fever 596 

Fever and ague, Homeopathic treatment 680 
Fever, Bilious, Homeopathic treatment 677 
Fever, Brain 425 
Fever, Breakbone 400 
Fever, Cerebral 425 
Fever, Childbed 494 
Fever, Condition of the bowels in 259 
Fever, Degrees of 192 
Fever, Diet in 259, 278, 281 
Fever, Enteric 410 
Fever, Homeopathic treatment 679 
Fever, Intermittent 406 
Fever, Lung 349 

Fever, Milk, Homeopathic treatment 682 
Fever of children, Cerebro-spinal 559 
Fever, Osteopathic treatment 694 
Fever, Puerperal, Homeopathic treatment 
684 



8 5 2 



INDEX. 



Fever, Remittent 406 

Fever, Remittent, Homeopathic treatment 

677 
Fever, Rheumatic 432 
Fever, Scarlet 563 

Fever, Scarlet, Homeopathic treatment 684 
Fever, Slow, Homeopathic treatment 685 
Fever sore 332 
Fever, Thermic 601 
Fever twig 642 
Fever, Typhoid 410 

Fever, Typhoid, Homeopathic treatment 685 
Fever, Typhus 413 
Fever, Winter 349 
Fever, Yellow 414 

Fever, Yellow, Homeopathic treatment 686 
Fevers, Eruptive, Table of 223 
Fevers, Nursing in 257 
Fevers, Symptoms of 203 
Fevers, Temperature in 258 
Fibers 715 
Fibrils 727 
Fibrin 717 
Fibula 728 

Fingers, Bones of the 726 
Fingers, Dislocation of the 594 
Fingers, Fracture of the 592 
Finsen light 711 
Fireplaces and grates 139 
Fistula 383 
Fits 559 

Fits, Homeopathic treatment 677 
Fixed oils 807 
Flats versus houses 127 
Flaxseed 803 
Flesh brush 56 
Flesh-forming food 29 
Fletcherism 27 

Floating specks before the eyes 104 
Flooding 469 
Floors, Hard oiled 134 
Flour, Common white 478 
Flour as a food, Value of 32 
Flowers in the sick room 263 
Fluidextracts 798 
Fluoroscope, The 696 
Fly agaric, Poisoning by 620 
Fly amanita, Poisoning by 620 
Fly killer, Poisoning by 620 
Fly fungus, Poisoning by 620 
Fly poison, Poisoning by 615 
Food 26 

Food, Albuminous 30 
Food, Carbonaceous 30 
Food, Classification of 29 
Food, Concentrated 41 
Food, Daily amount of 42 
Food, Deficiency of 29 
Food, Digestibility of 32 
Food, Dyed 37 
Food, Fats 30 
Food, Flesh-forming 29 
Food for the sick 277 
Food for the sick, Assistance to patient 280 



Food for the sick, How to prepare 277 

Food for the sick, How to serve 277 

Food for the sick, Time of feeding 280 

Food for tooth-building 478 

Food, Heat-producing 30 

Food, How to detect impure 36 

Food, Insalivation of 46 

Food, Mastication of 46 

Food, Mineral matter in 30 

Food, Nitrogenous 29 

Food, Poisoning by 615 

Food, Predigested 41 

Food, Pure 36 

Food, Selection of 27 

Food, Service of 279 

Food, Table of digestibility of 33 

Food values, Table of 32 

Food, Water in 30 

Foods, Farinaceous 295 

Foods, Infant 517 

Foods, Peptonized, To prepare 287 

Foot, Bones of the 730 

Foot, Muscles of the sole of the 735 

Formaldehyde a disinfectant 161 

Formaldehyde, Solution of 804 

Formalin a disinfectant 161 

Foreign bodies located by X-ray 702 

Fountain syringe 244 

Fowler's solution 804 

Foxglove 785, 794 

Fracture of the arm 590 

Fracture of the collar bone 591 

Fracture of the jaw 591 

Fracture of the kneecap 592 

Fracture of the leg 590 

Fracture of the ribs 591 

Fracture of the skull 591 

Fracture of the spine 591 

Fractures detected by X-ray 701 

Frangula 799 

Frangula, Fluidextract of 798 

Freckles, 57, 451, 764 

Freckles, Cream for 57 

Freckles, Healing lotion for 58 

Freckles, Lotion for 57 

Freckles, Ointment for permanent 58 

Freckles, Permanent 58 

Freckles, Wash for permanent 58 

Fresh air, a disinfectant 158 

Fresh air, amount required 86 

Friar's balsam 821 

Frostbite 602 

Fruit, Unripe 40 

Furnaces 138 

Furunculus 458 

Galactagogues 782 

Gallbladder 761 

Gallic acid 784 

Gallstones 386 

Gallstones, Homeopathic treatment 680 

Galvanic electricity 709 

Galvanic electricity. Uses of 709 



INDEX. 



853 



Galvanism 709 

Gambir 800 

Gambir, Compound tincture of 822 

Gambir, Troches of 823 

Gangrene, Homeopathic treatment 680 

Garden nightshade 641 

Gas 141 

Gas light, Incandescent 142 

Gas, Poisoning by 614 

Gasoline generators 142 

Gastralgia 365 

Gastralgia of children 550 

Gastric cancer 369 

Gastric juice 758 

Gastric tonics 783 

Gastric ulcer 368 

Gastric vertigo 442 

Gastritis, Acute 362 

Gastritis, Homeopathic treatment 681 

Gavage 504 

Gelatine 800 

Gelatine, Glycerinated 800 

Gelsemium 800 

Gelsemium, Fluidextract of 798 

Gelsemium sempervirens 639 

Gelsemium, Tincture of 822 

General diseases of adults 417 

Generative organs 766 

Gentian 800 

Gentian, Compound tincture of 822 

Gentian, Extract of 796 

Gentian, Fluidextract of 798 

Geranium 800 

Geranium, Fluidextract of 798 

German chamomile 806 

German measles 566 

German measles caused by impure air 86 

German measles, Means of preventing 154 

Ginger 826 

Ginger, Fluidextract of 799 

Ginger, Syrup of 821 

Ginger, Tincture of 823 

Glanders 408 

Glandular swellings, Homeopathic treatment 
680 

Glauber's salts 817 

Glenoin, Spirit of 818 

Glossitis 334 

Glossitis, Homeopathic treatment 681 

Glottis 741 

Glottis, Spasm of the 558 

Glottis, Spasm of the, Homeopathic treat- 
ment 685 

Glucose, Test for presence of 37 

Gluten, Definition of 30 

Glycerinated gelatine 800 

Glycerine 800 

Glycerine of alum 800 

Glycerine of borax 800 

Glycerine suppositories 819 

Glycerite of boroglycerine 800 

Glycerite of hydrastis 800 

Glycerite of phenol 800 

Glycerite of phosphates of iron, quinine, 
and strychnine 800 



Glycerite of starch 800 

Glycerite of tannic acid 800 

Glycerol 800 

Glycogen 717, 761 

Glycyrrhiza 800 

Glycyrrhiza and opium, Troches of 823 

Glycyrrhiza, Compound mixture of 806 

Glycyrrhiza, Compound powder of 813 

Glycyrrhiza, Extract of 796 

Glycyrrhiza, Fluidextract of 798 

Gold, Poisoning by 616 

Goldenseal 801 

Gonococcus 317 

Gooseberries as food, Value of 32 

Goulard's cerate 792 

Goulard's extract 804 

Gout, Diet in 286 

Gout, Homeopathic treatment 680 

Granular lids 313 

Grapes as a food, Value of 32 

Gravel 396 

Green sickness 439 

Gregory's powder 813 

Griffith's mixture 806 

Grindelia 800 

Grindelia, Fluidextract of 798 

Gross's pill for neuralgia 438 

Grounds around a house 132 

Growth during infancy 508 

Gruel, Arrowroot 296 

Gruel, Ground rice 296 

Gruel, Indian meal 295 

Gruel, Oatmeal 295 

Gruel, Sago 296 

Gruel, Water 296 

Guaiacol 800 

Guaiacol carbonate 801 

Guaiacum 801 

Guaiacum, Ammoniated tincture of 822 

Guaiacum, Tincture of 822 

Guarana 801 

Guarana, Fluidextract of 798 

Gum arabic 784 

Gumboil 333 

Gumboil, Homeopathic treatment 680 

Gums, Lancing the 538 

Gums, Wash for inflamed 479 

Gun cotton 793 

Gun cotton, Soluble 814 

Gustatory nerve 774 

Haddock as food, Value of 32 

Haematoxylon 801 

Haematoxylon, Extract of 796 

Haemoglobin 748 

Haemostatics 782 

Hahnemann, Samuel 674 

Hamamelis bark 801 

Hamamelis leaves, Fluidextract of 798 

Hamamelis water 788 

Hair, Bleaching the 73 

Hair, Care of the 65 

Hair, Cleanliness of 66 

Hair, Color of the 66 

Hair dye 73 



854 



INDEX, 



Hair, Falling 70 

Hair, Falling of, Homeopathic treatment 679 

Hair, Lotion for darkening the 72 

Hair, Lotion for falling 70 

Hair, Massage of the 68 

Hair, Structure of 764 

Hair, Superfluous 73 

Hair, Ventilation of the 68 

Hair, Washing the 67 

Hairs of the nose 93 

Halls of a house 133 

Hand, Bones of the 726 

Hands, Massage for the 277 

Hard palate 742 

Hard water 43 

Hardening children 64 

Harelip 533 

Hay asthma 347 

Hay asthma, Homeopathic treatment 680 

Hay fever 347 

Hay fever, Homeopathic treatment 680 

Head, Bones of the 725 

Head, Cold in the 92, 327 

Head, Defense and protection of the 604 

Head, Diseases of the 303 

Head, Injuries of the 604 

Headache, Anaemic 310 

Headache, Bilious 307 

Headache, Blind 307 

Headache, Congestive 309 

Headache, Homeopathic treatment 680 

Headache, Neuralgic 306 

Headache, Neuralgic, Causes of 306 

Headache, Neuralgic, Treatment of 307 

Headache, Neuralgic, Symptoms of 306 

Headache of eye-strain 3 1 

Headache of kidney disease 310 

Headache of nervous debility 310 

Headache of neurasthenia 310 

Headache, Organic 310 

Headache, Periodic 309 

Headache, Periodic, Homeopathic treatment 
683 

Headache powders, Danger of using 660 

Headache, Rheumatic 308 

Headache, Rheumatic, Homeopathic treat- 
ment 684 

Headache, Sick 307 

Health, definition 25 

Health, Maintenance of 25 

Hearing, Helps to 98 

Hearing of infants 511 

Hearing, Tests for 96 

Heart 744 

Heart, Atrophy of the 361 

Heart, Beating of the 746 

Heart, Dilatation of the 355 

Heart, Diseases of the 193, 355 

Heart, Diseases of the, Homeopathic treat- 
ment 678 

Heart, Enlargement of ventricles of the 360 

Heart, Inflammation of the 356 

Heart, Left side of 743 

Heart, Neuralgia of the 359 



Heart, Palpitation of the 357 

Heart, Papillary muscles 744 

Heart, Rapid 358 

Heart, Shrinking of the 361 

Heart, Slow 359 

Heart, Sounds of the 746 

Heart stimulants, List of 612 

Heartburn during pregnancy 482 

Heat a disinfectant 158 

Heat exhaustion 601 

Eeat stroke 601 

Heating a house 138 

Hedeoma 801 

Height of infants 509 

Height, Table of 510 

Helenium autumnale 643 

Hemiplegia defined 428 

Hemlock, Poison 794 

Hemlock, Water, Poisoning by 636 

Hemoglobin defined 439 

Hemoptysis 348 

Hemoptysis, Homeopathic treatment 677 

Hemorrhage, Cerebral 417 

Hemorrhage, Uterine 469 

Hemorrhoids 381 

Hemorrhoids during pregnancy 484 

Hemorrhoids, Homeopathic treatment 683 

Henbane 802 

Hepatic duct 760 

Herbbennet 637 

Heredity a predisposing cause to disease 147 

Hernia, Umbilical 502 

Herpes 455 

Herpes labialis 332 

Hiccough, Homeopathic treatment 680 

High laurel 639 

Hip joint disease, Homeopathic treatment 680 

Hip joint, Ligaments of 730 

Histology defined 715 

Hives 450 

Hoarhound 805 

Hoarseness 338 

Hoarseness, Homeopathic treatment 680 

Hoffman's anodyne 817 

Homatropine hydrobromide 801 

Homeopathic schools 675 

Homeopathic treatment of disease 676 

Homeopathy 674 

Homeopathy, Essentials of 675 

Homeopathy in America 674 

Homeopathy in Europe 674 

Homeopathy, Law of similars 675 

Homeopathy,Provings 675 

Honey 806 

Honey of borax 806 

Honey of rose 806 

Hop poultice 240 

Hops 801 

Hordeolum 314 

Hordeolum, Homeopathic treatment 685 

Horehound 805 

Horse-chestnut, Poisoning by 635 

Hot applications 256 

Hot bath 53 



INDEX. 



855 



Hot pack 230 

Hot water bottle 243 

House cleaning 134 

House, Grounds around a 132 

House, How to choose a 127 

House, Interior of a 133 

House, Location of the 126 

House, The country 128 

House walls, The 130 

House, Water near the 130 

Humerus 726 

Humulus 801 

Hunyadi Janos water, Analysis of 708 

Hydragogues 782 

Hydrargyri chloridum corrosivum 801 

Hydrargyri chloridum mite 801 

Hydrargyri iodidum flavum 801 

Hydrargyri iodidum rubrum 801 

Hydrargyri oxidum flavum 801 

Hydrargyri oxidum rubrum 801 

Hydrargyrum ammoniatum 801 

Hydrargyrum cum creta 801 

Hydrastine 801 

Hydrastinine hydrochloride 801 

Hydrastis 801 

Hydrastis, Fluidextract of 798 

Hydrastis, Glycerite of 800 

Hydrastis, Tincture of 822 

Hydrated chloral 792 

Hydriodic acid, Syrup of 819 

Hydrochloric acid 785 

Hydrocyanic (Prussic) acid, Poisoning by 613 

Hydropathy 706 

Hydrophobia 402, 601 

Hydrophobia, Means of preventing 157 

Hydrophobia, Symptoms of, in dogs 403 

Hydrotherapy 706 

Hydrothorax 344 

Hygeia 25 

Hygiene and care of the digestive apparatus 

26 
Hygiene, definition 25 
Hygiene, Domestic 126 
Hygiene, Personal 25 

Hygienic conditions a cause of disease 148 
Hyoglossus muscle 732 
Hyoid bone 718 

Hyoscyamine hydrobromide 802 
Hyoscyamine sulphate 802 
Hyoscyamus 796, 802 
Hyoscyamus, Fluidextract of 799 
Hyoscyamus, Poisoning by 616 
Hyoscyamus, Tincture of 822 
Hyperidrosis 459 
Hypermetropic eyes 769 
Hyperopia 100 
Hypnosis 712 
Hypnotic, Anodyne 783 
Hypnotics 782 
Hypnotism in surgery 712 

Hypochondria, Homeopathic treatment of 680 
Hypophosphites, Compound syrup of 820 
Hypophosphites, Syrup of 820 
Hyperdermic injections 236 



Hysteria, Electrical treatment 710 
Hysteria, Homeopathic treatment 680 

Ice bag 241 

Icterus 385 

Idiopathic disease defined 422 

Impure food, How to detect 36 

Incontinency of urine 395 

Incontinence of urine, Homeopathic treat- 
ment 680 

Incubation of disease 151 

Incubator 503 

Indian cannabis, Extract of 796 

Indian cannabis, Fluidextract of 798 

Indian cannabis, Tincture of 821 

Indian hemp, Fluidextract of 798 

Indian tobacco 645 

Indigestion 365 

Indigestion, Homeopathic treatment 679 

Indigestion, Intestinal 371 

Indigestion of childhood, Acute stomach 550 

Infant foods 517 

Infantile spasms 595 

Infantile spinal paralysis, Electrical treat- 
ment 710 

Infectious diseases, General rules for pre- 
vention of 152 

Infectious diseases of adults 400 

Infectious diseases of children 559 

Infectious diseases, Special rules for pre- 
vention of 154 

Inferior maxillary bone, 716, 718 

Inflammatory blush, Homeopathic treatment 
681 

Influenza 404 

Influenza caused by impure air 86 

Influenza, Homeopathic treatment 681 

Influenza, Means of preventing 155 

Infusion of digitalis 802 

Infusion of senna, Compound 802 

Infusion of wild cherry 802 

Infusions 802 

Ingrowing nails 447 

Injured, Carrying upstairs 571 

Injured, Lifting into bed 571 

Injured persons, Carrying 571 

Injured, Removing clothing of the 571 

Injurious habits and their effects 646 

Ink, Poisoning by 616 

Inflammation of bowels, Cold applications 257 

Insalivation 46 

Insane, Safeguards of the 668 

Insane, Treatment of the 668 

Insanity 663 

Insanity, Rural 667 

Insects, Bites and stings of 598 

Insomnia 121 

Insomnia during pregnancy 483 

Insomnia, Walking a cure for 115 

Insomnia, Warm bath in 52 

Intercostal muscles 732 

Intermittent fever 406 

Intermittent fever, Homeopathic treatment 
680 



8 5 6 



INDEX. 



Intervertebral foramina 725 

Intestines 758 

Intestines, Coats of the 759 

Invasion of disease 151 

Iodide of mercury, Red 801 

Iodide of mercury, Yellow 801 

Iodine 802 

Iodine, Compound solution of 804 

Iodine ointment 824 

Iodine, Poisoning by 616 

Iodine, Tincture of 822 

Iodoform 802 

Iodoform ointment 824 

Iodol 802 

Ipecac 802 

Ipecac an emetic 612 

Ipecac and opium, Powder of 813 

Ipecac and opium, Tincture of 822 

Ipecac, Fluidextract of 799 

Ipecac, Wine of 826 

Iris 768 

Iron and ammonium acetate, Solution of 804 

Iron and ammonium citrate 797 

Iron and ammonium tartrate 797 

Iron and potassium tartrate 797 

Iron and quinine citrate 797 

Iron and strychnine citrate 797 

Iron, Bitter wine of 826 

Iron mixture, Compound 806 

Iron, Reduced 797 

Iron waters 707 

Iron, Wine of 825 

Irregular meals 27 

Irritant poisons 611 

Irritation 453 

Ischium 724 

Itch 454 

Itch, Homeopathic treatment 682 

Itching 453 

Itching of the genital organs, Homeopathic 

treatment 682 
Itching, Homeopathic treatment 682 
Itching of the scalp 70 
Ivy 638 
Ivy bush 639 
Ivy wood 639 

Jaborandi 811 

Jalap 802 

Jalap, Powder of 813 

Jalap, Resin of 814 

Jamestown lily 641 

Jamestown weed 640 

Jaundice 385 

Jaundice, Early symptoms of 205 

Jaundice, Homeopathic treatment 682 

Jaundice of infants, Homeopathic treatment 

682 
Jaundice of newborn child 498 
Jaw, Dislocation of the lower 593 
Jaw, Fracture of the 591 
Jejunum 759 
Jessamine, False 639 
Jimson weed 640 



Joint, Ball and socket 723 

Joint, Gliding 723 

Joint, Hinge 723 

Joint of the wrist 728 

Joint, Pivot 723 

Joints 719 

Joints, Inflammation of the 430 

Joints, Stiffness of the 432 

Joints, Varieties of 723 

Jugular veins 750 

Juniper, Compound spirit of 818 

Juniper, Oil of 809 

Juniper tar, Oil of 808 

Junket 289 

Junket, Champagne 292 

Junket, Coffee 290 

Junket, Custard 291 

Junket, Devonshire 290 

Junket, Eggnog 292 

Junket from cream 291 

Junket, Wine 292 

Junket with raw egg 292 

Kalmia 639 

Kalmia angustifolia 639 

Kalmia latifolia 638 

Kaolin 802 

Kidney, Congestion of, symptoms 201 

Kidney, Cortical portion 764 

Kidney, Granular portion 765 

Kidney, Medullary portion 765 

Kidney, Section through the 43 

Kidneys 764 

Kidneys, Congestion of the 391 

Kidneys, Diseases of the 389 

Kidneys, Inflammation of the, Homeopathic 

treatment 681 
Kino 787, 802 
Kino, Tincture 822 
Kissingen water, Analysis of 709 
Kitchen, The 135 
Kneecap, Fracture of the 592 
Knock knees 107 
Knuckles, Cracking the 107 
Krameria 802 
Krameria, Extract of 796 
Krameria, Fluidextract 799 
Krameria, Syrup of 820 
Krameria, Tincture of 822 
Krameria, Troches of 824 
Koumyss 293 

Labarraque's solution 804 
Labyrinth, Membranous 772 
Labyrinth of the ear 770, 772 
Lachrymal canal 718 
Lachrymal groove 716 
Lactic acid 785 
Lactucarium 802 
Lactucarium, Syrup of 820 
Lactucarium, Tincture of 822 
Lady Webster pills 811 
La Grippe 404 
Lamb broth 294 



INDEX. 



857 



Lapacticpill 812 

Lappa 802 

Lappa, Fluidextract of 799 

Lard 802 

Lard oil 808 

Laryngitis 338 

Laryngitis, Homeopathic treatment 681 

Laryngitis, Oedematous 340 

Larynx 741 

Larynx, Cartilages of the 741 

Larynx, Dropsical inflammation of the 340 

Larynx, Inflammation of the, Homeopathic 

treatment 681 
Laudanum 822 
Laudanum, Poisoning by 616 
Laughing gas, Poisoning by 616 
Laurel 638 

Laurel, Broad-leaf 638 
Lavender, Compound tincture of 822 
Lavender flowers, Oil of 809 
Lavender, Spirit of 818 
Laxatives 778, 783 
Lead plaster 795 
Lead salts, Poisoning by 616 
Lead subacetate, Cerate of 792 
Lead subacetate solution 804 
Leg and arm compared 723 
Leg, Fracture of the 590 
Leg, Muscles of the 736 
Legs, Bones of the 721 
Legs, Cramp of the, Homeopathic treatment 

678 
Lemon flavoring, To examine 39 
Lemon juice 803 
Lemon, Oil of 809 
Lemon peel 803 
Lemon peel, Tincture of 822 
Leptandra 803 
Leptandra, Extract of 796 
Leptandra, Fluidextract of 799 
Leucorrhoea 470 

Leucorrhoea, Homeopathic treatment 686 
Lice 460 

Lice, Homeopathic treatment 682 
Lichen 453 

LicDrice, Compound powder of 813 
Licorice, Extract of 796 
Licorice root 800 
Ligaments 108 
Light, Position of the 143 
Lighting a house 141 
Lightning stroke 602 
Lily of the valley 794 
Lime liniment 803 
Lime, Syrup of 819 
Lime water 803 
Liniments 241, 803 
Linseed 803 
Linseed oil 809 
Lips, Chapped 332 
Lips, Cracked 332 
Lips, Cracked or chapped, Homeopathic 

treatment 677 
Liquor f erri et ammonii acetatis 804 



Lithium benzoate 804 

Lithium bromide 805 

Lithium carbonate 805 

Lithium citrate 805 

Lithium salicylate 805 

Litmus paper 479 

Liver 760 

Liver, Cancer of the 388 

Liver, Congestion of the 387 

Liver diseases, Diet in 283 

Liver, Diseases of the 385 

Liver, Gin drinker's 388 

Liver, Inflammation of the, Homeopathic 

treatment 681 
Liver, Lobes of the 760 
Liver, Lobules of the 761 
Liver, Size of 760 
Liver spots, Wash for 59 
Lye, Burns with 598 
Lizard, Poisonous 600 
Lobelia 805 

Lobelia, Fluidextract of 799 
.Lobelia inflata 645 
Lobelia, Poisoning by 616 
Lobelia, Tincture of 822 
Lochia, The 492 
Lockjaw 405 

Lockjaw, Antitoxin in 705 
Lockjaw, Homeopathic treatment 682 
Lockjaw, Means of preventing 157 
Lockjaw of newborn child 500 
Locomotor ataxia 427 

Locomotor ataxia, Electrical treatment 710 
Logwood 801 
Logwood, Extract of 796 
Longing in pregnancy 475 
Longus colli muscle 732 
Lower jaw bone 718 
Lugol's solution 804 
Lumbago 435 
Lumbago, Homeopathic treatment of 676, 

682 
Lumbricales muscle 737 
Lunar caustic 789 
Lung fever 349 
Lung test in infancy 754 
Lungs 753 

Lungs benefited by exercise 110 
Lungs, Bleeding from the 348 
Lungs, Bleeding from the, Homeopathic 

treatment 677 
Lungs, Diseases of the 340 
Lungs of an infant 754 
Lungs, Work done by the 755 
Lupulin 805 

Lupulin, Fluidextract 799 
Lycopodium 805 

Mad apple 641 
Magnesium carbonate 805 
Magnesium citrate, Solution of 804 
Magnesium sulphate 805 
Maintenance of health 25 
Malar or cheek bone 716, 718 



8 5 8 



INDEX. 



Malaria 406 

Malaria, Homeopathic treatment 680 

Malaria, Means of preventing 156 

Malt, Extract of 797 

Mandrake root 812 

Manganese dioxide, Precipitated 805 

Manganese hypophosphite 805 

Manganese sulphate 805 

Mania a potu 652 

Manicuring 75 

Manicuring, Materials for 76 

Manna 805 

Marasmus 530 

Marrubium 805 

Mass, Blue 805 

Mass of ferrous carbonate 805 

Mass of mercury 805 

Mass, Vallet's 805 

Massage, Beauty 272 

Massage, Beauty treatment 267 

Massage, Benefit of 267 

Massage for bruises 272 

Massage for the chest 276 

Massage for the hands 277 

Massage for the neck 276 

Massage for sprains 272 

Massage for wrinkles 273 

Massage, French system 267 

Massage, General 266 

Massage, German system 267 

Massage, How to give 270 

Massage of the arms 277 

Massage of the face 274 

Massage of the head 68 

Massage, System in giving 269 

Massage, When to give 267 

Mastic 805 

Mastication of food 46 

Mastiche 805 

Mastoid process 716, 718 

Matches, Poisoning by 616 

Materia medica 775 

Matico 806 

Matico, Fluidextract of 799 

Matricaria 806 

May-apple 812 

Meadow saffron 793 

Meals, Irregular 27 

Measles 565 

Measles caused by impure air 86 

Measles, Early symptoms of 204 

Measles, Homeopathic treatment 682 

Measles, Means of preventing 154 

Meatus auditorius 771 

Meconium 496 

Medication 249 

Medicine glass 244 

Medicines absorbed through the skin 51 

Medulla oblongata 740 

Medulla of kidney 743 

Medullary rays of kidney 743 

Mel 806 

Melboracis 806 

Melrosae 806 



Melancholy during pregnancy 483 

Melons as food, Value of 32 

Meniere's disease 442 

Meningitis, Acute 425 

Meningitis, Cerebro-spinal 559 

Menopause 467 

Menorrhagia 466 

Menorrhagia, Homeopathic treatment 683 

Menses, Cessation of 467 

Menses, Cessation of the, Homeopathic treat- 
ment 671 

Menses, Obstructed, Homeopathic treatment 
683 

Menstruation 461 

Menstruation, Cessation of 467 

Menstruation, Delayed 463 

Menstruation, Delayed, Homeopathic treat- 
ment 678 

Menstruation, Obstructed 463 

Menstruation, Painful 466 

Menstruation, Painful, Homeopathic treat- 
ment 683 

Menstruation, Profuse 466 

Menstruation, Profuse, Homeopathic treat- 
ment 683 

Menstruation, Suppressed 464 

Mental foramen 716 

Mentha piperita 806 

Mentha virides 806 

Menthol 806 

Mercurial ointment 824 

Mercurial stomatitis 333 

Mercuric nitrate, Solution of 804 

Mercury, Ammoniated 801 

Mercury, Bichloride of 801 

Mercury, Mass of 805 

Mercury ointment, Ammoniated 824 

Mercury plaster 795 

Mercury, Poisoning by 616 

Mercury, Red iodide of 801 

Mercury, Red oxide of 801 

Mercury with chalk 801 

Mercury, Yellow iodide of 801 

Mercury, Yellow oxide of 801 

Metabolism 715 

Metacarpal bones 726 

Metadihydroxybenzene 814 

Metatarsal bones 730 

Methylene blue 806 

Methylthionine hydrochloride 806 

Methyl salicylate 806 

Metrorrhagia 466 

Mezereum 806 

Mezereum, Fluidextract of 799 

Micrococcus pyogenes 157 

Migraine 307 

Mild mercurous chloride 801 

Milk an ideal food 31 

Milk an ideal food for children 31 

Milk, Analysis of cow's 519 

Milk, Analysis of mother's 519 

Milk and eggs 300 

Milk as food, Value of 32 

Milk, Composition of 31 



INDEX. 



859 



Milk, Condensed 517 

Milk, Cow's 518 

Milk crust eczema 456 

Milk fever, Homeopathic treatment 682 

Milk, Formulas for modified 522 

Milk gruel, Peptonized 288 

Milk leg, Homeopathic treatment 682 

Milk, Modified cow's 520 

Milk, Modification of cow's 518 

Milk, Partially peptonized 288 

Milk, Pasteurization of 159 

Milk, Pasteurizing 516 

Milk, Peptonized 288 

Milk, Peptonizing 516 

Milk, Preservatives used in 39 

Milk sickness 363 

Milk, Sterilization of 159 

Milk, Sterilizing 515 

Milk, Test for coloring matter in 38 

Milk, Thickened 296 

Milk, To detect adulteration of 39 

Milk, To test for purity 39 

Milk, Why it is necessary to modify 519 

Mindereus, Spirit of 803 

Mineral matter in food 30 

Mistura 806 

Mistura cretae 806 

Mistura ferri composita 806 

Mistura glycyrrhiza composita 806 

Mistura rhei et sodse 806 

Mitigated silver nitrate 789 

Mitral valve 743 

Mixed feeding 512 

Mixture, Brown 806 

Mixture, Chalk 806 

Mixture, Compound iron 806 

Mixture, Griffith's 806 

Mixture of glycyrrhiza, Compound 806 

Mixture of rhubarb and soda 806 

Moderation in eating 28 

Modified cow's milk 520 

Moisture in the air 138 

Moles 451 

Monkshood 786 

Monsell's solution 804 

Monster of Gila 600 

Moral influence on pregnancy 476 

Morning sickness 474 

Morning sickness, Homeopathic treatment 

678 
Morning sickness, Treatment of 481 
Morphine 806 
Morphine acetate 806 
Morphine, Compound powder of 813 
Morphine habit 662 
Morphine hydrochloride 806 
Morphine, Poisoning by 616 
Morphine sulphate 806 
Mortification, Homeopathic treatment 680 
Moschus 807 
Motherhood 461 
Motherhood, Diseases of 472 
Mothers who should not nurse 512 
Moulded silver nitrate 789 



Mountain ivy 639 

Mountain laurel 638 

Mouth, Aphthous sore, Homeopathic treat- 
ment 685 

Mouth breathing 92 

Mouth breathing, Deformity caused by 92 

Mouth, Canker of the, Homeopathic treat- 
ment 677 

Mouth, Catarrh of the, in children 542 

Mouth cavity 742 

Mouth, Diseases of the 332 

Mouth, Putrid sore 544 

Mouthwashes 241 

Mouth washes in sickness 254 

Mouth, White 544 

Miscarriage 485 

Mucilage of acacia 807 

Mucilage of elm 807 

Mucilage of sassafras 807 

Mucilage of tragacanth 807 

Mucous coat of the stomach 758 • 

Muguet 544 

Multiple neuritis, Electrical treatment 709 

Mumps 562 

Mumps, Homeopathic treatment 682 

Mumps caused by impure air 86 

Mumps, Means of preventing 155 

Muscae volitantes 104 

Muscle, Smooth 727 

Muscle, Striated 727 

Muscles 725 

Muscles, Biceps 727 

Muscles, Bipenniform 727 

Muscles, Care of the 109 

Muscle, Ciliary 769 

Muscles, Digastric 727 

Muscles, Involuntary 729 

Muscles of the forearm 737 

Muscles of infants 511 

Muscles of the leg 736 

Muscles of the neck 732 

Muscles of the sole of the foot 735 

Muscles of the thigh 735 

Muscles of the trunk 733 

Muscles of the upper arm 735 

Muscles, Penniform 727 

Muscles, Polygastric 727 

Muscles, Simple 727 

Muscles, Triceps 727 

Muscles, Varieties of 727 

Muscles, Voluntary 729 

Muscles, Weariness of 729 

Muscular coat of the stomach 758 

Muscular rheumatism 435 

Mush 297 

Mushrooms, Poisoning by 616 

Musk 807 

Musk, Tincture of 822 

Muskrat weed 636 

Muskroot 819 

Musquash root 636 

Mustard an emetic 612 

Mustard, Black 816 

Mustard papers 792 



86o 



INDEX, 



Mustard paste for children 237 

Mustard plaster, To make a 236 

Mustard, Volatile oil of 809 

Mustard, White 816 

Mutton as a food, Value of 32 

Mutton tea 294 

Mydriatics 783 

Myolemma 727 

Myopic eyes 769 

Myosin 717 

Myotics 783 

Myristica 807 

Myrrh 807 

Myrrh, Tincture of 822 

Nails, Care of the 74 

Nails, Ingrowing 447 
Nails, Manicuring the 75 

Nails, Powder for polishing the 77 

Nails, Rose paste for the 77 

Naphthalene 807 

Narcotic poisons 611 

Narcotics 783 

Narrow-leaved laurel 639 

Nasal bone 716 

Nasal catarrh, Chronic 328 

Nasal cavities 718 

Nasal douche 242 

Nausea and vomiting 364 

Nausea, Homeopathic treatment 682 

Nausea in pregnancy, Homeopathic treat- 
ment 678 

Navel, Inflammation of the 501 

Navel, Rupture of the 502 

Nearsightedness 100, 769 

Neck, Massage of the 276 

Neck, Stiff 435 

Neck, Stiff. Homeopathic treatment 685 

Neck, Wry 435 

Neckwear, Evils of tight 64 

Necrosis of bone 108 

Nerve, Glossopharyngeal 774 

Nerve, Gustatory 774 

Nerve of accommodation 103 

Nerve, Olfactory 740 

Nerves 755 

Nerves, Gray matter 755 

Nerves of the body 691 

Nerves, White matter 755 

Nervous prostration 122, 426 

Nervous prostration, Electrical treatment 
710 

Nervous system 121, 756 

Nervous system improved by exercise 111 

Nervous vertigo 442, 603 

Nettle rash 450 

Neuralgia 436, 596 

Neuralgia, Homeopathic treatment 682 

Neuralgic headache 306 

Neurasthenia 122, 426 

Neurasthenia, Electrical treatment 710 

Neuritis, Electrical treatment 710 

Neurohypnotism 712 

Neutral mixture 804 



Newborn children, Diseases of 496 

Nicotine, Poisoning by 616 

Nightmare, Homeopathic treatment 683 

Nightshade 641 

Nightshade vine 642 

Nipples, Homeopathic treatment 685 . 

Nitre 813 

Nitre, Sweet spirit of 817 

Nitric acid 785 

Nitrogen 85 

Nitrogenous food 29 

Nitroglycerine, Spirit of 818 

Nitrohydrochloric acid 785 

Nitromuriatic acid 785 

Nitrous oxide, Poisoning by 616 

Nose, Blowing the 93 

Nose breathing 79, 90 

Nose, Care of the 91 

Nose, Diseases of the 327 

Nose, Foreign bodies in the 93, 331 

Nose, Hairs of the 93 

Nose, Inflamed 329 

Nose, Inflamed, Homeopathic treatment 681 

Nose, Obstructions in the 91 

Nose, Polypus of the 92, 331 

Nose, Septum of 740 

Nose, Structure of 740 

Nose, Ulcerated 329 

Nose, Ulcerated, Homeopathic treatment 681 

Nosebleed 330 

Nosebleed, Homeopathic treatment 677 

Nucleolus 715 

Nucleus 715 

Nurse, Mothers who should not 512 

Nurse, The wet 512 

Nurse, Training a child to 513 

Nursery, The 504 

Nursing in fevers 257 

Nursing, Home 225 

Nursing, Modern 225 

Nursing sick children 261 

Nursing suggestions 263 

Nursing, Surgical 260 

Nutgall ointment 824 

Nutgall, Tincture of 822 

Nutmeg 807 

Nutmeg, Oil of 809 

Nutrition 756 

Nux vomica 807 

Nux vomica, Extract of 797 

Nux vomica, Fluidextract 799 

Nux vomica, Poisoning by 616 

Nux vomica, Tincture of 822 

Oatmeal 297 

Oatmeal as a food, Value of 32 

Oatmeal jelly 297 

Obesity, Diet in 285 

Obstetrical table 473 

Occupation and diet 35 

Occupations, Dangerous 79 

Ocular vertigo 442 

Oculist, Need of an 99 

Oil glands 50 



INDEX. 



861 



Oil glands, Disorders of the 452 

Oil, Olive 809 

Oils 807 

Oils, Fixed 807 

Oils, Volatile 807 

Ointments 824 

Oid age, Brain in 731 

Old age, Care of the bones 108 

Oleic acid 785 

Olein 717 

Oleomargarine, How to detect 38 

Olfactory nerve 740 

Olive oil 809 

Olive oil as a food, Value of 32 

Omphalitis 501 

Ophthalmia, Homeopathic treatment 681 

Ophthalmia of newborn child 500 

Ophthalmia, Purulent, Homeopathic treat- 
ment 684 

Opium 810 

Opium, Camphorated tincture of 822 

Opium, Extract of 797 

Opium, Pills of 812 

Opium, Plaster 795 

Opium, Poisoning by 617 

Opium, Tincture 822 

Opium, Tincture, Camphorated of 822 

Opium, Wine of 826 

Orange, Compound spirit of 817 

Orange flower water 788 

Orange peel 790 

Orange peel, Fluidextract of bitter 798 

Orange peel, Oil of 808 

Orange, Syrup of 819 

Oregon water hemlock 636 

Os calcis 730 

Osteopathic corrective treatment 692 

Osteopathic diagnosis 689 

Osteopathic manipulation 692 

Osteopathic treatment of diseases of women 
693 

Osteopathy 687 

Osteopathy, Definition of 687 

Osteopathy, Founding of 687 

Osteopathy, Practical therapeutics of 689 

Otalgia 322 

Otalgia, Homeopathic treatment 679 

Otitis 323 

Otitis, Homeopathic treatment 681 

Oval foramen of skull 716 

Ovaries 461, 766 

Ovaries, Inflammation of the 470 

Ovaries, Inflammation of the, Homeopathic 
treatment 681 

Ovaritis 470 

Ovaritis, Homeopathic treatment 681 

Overeating 28 

Overstudy 124 

Ox eye 643 

Oxalic acid 789 

Oxalic acid, Poisoning by 617 

Oxgall 797 

Oxgall, Purified 797 

Oxidation 158, 757 



Oxide of mercury, Red 801 
Oxide of mercury, Yellow 801 
Oxygen 85 

Oysters, Peptonized 295 
Oyster soup 294 

Pachymeningitis 424 

Packs, Hot and cold 230 

Pains in the side, Homeopathic treatment 
683 

Painter's colic 51, 378 

Palate, Cleft 533 

Palate, Hard 742 

Palate, Soft 742 

Pale catechu 800 

Palmitin 717 

Palpitation of the heart, Homeopathic treat- 
ment 683 

Palsy 428 

Palsy, Homeopathic treatment 683 

Panada 295 

Pancreatic juice 760 

Pancreatin 810 

Paraffine 810 

Paraldehyde 810 

Paralysis 428 

Paralysis agitans, Homeopathic treatment 683 

Paralysis, Electrical treatment 710 

Paralysis, Homeopathic treatment 683 

Paraplegia defined 428 

Parasites 150 

Paregoric 822 

Pareira 810 

Pareira, Fluidextract of 799 

Parotiditis 562 

Parietal bone 716, 718 

Paris green, Poisoning by 617 

Parturition 487 

Pasteurization of milk 159 

Pasteurizing milk 516 

Patella, Fracture of the 592 

Patent medicines, Alcohol in 646 

Patent medicines. Amount sold annually 647 

Patent medicines, Dangers of using 646 

Patient, How to turn the 229 

Peaches as food, Value of 32 

Pears as food, Value of 32 

Peas as a food, Value of 32 

Peeling skin, Lotion for 59 

Pelletierine tannate 810 

Pellitory 814 

Pelvis measured by X-ray 703 

Pennyroyal 801 

Pennyroyal, Oil of 809 

Pepo 810 

Pepper, Black 812 

Peppermint 806 

Peppermint, Oil of 809 

Peppermint, Spirit of 818 

Peppermint water 788 

Pepsin 810 

Peptonized foods, To prepare 287 

Peptonizing milk 516 

Perchloride of mercury a disinfectant 160 



862 



INDEX. 



Perchloride of mercury, Poisoning by 615 
Pericarditis 356 

Pericardium, Inflammation of the 356 
Peritoneum, Inflammation of the 382 
Peritoneum, Inflammation of the, Homeo- 
pathic treatment 681 
Peritonitis 382 

Peritonitis, Homeopathic treatment 681 
Peritonsilar abscess 338 
Peritonsilar abscess in children 547 
Permanganate of potash a disinfectant 162 
Peroxide 788 
Perspiration 763 
Perspiration, Excessive 459 
Perspiration glands 50 
Perspiration, Insensible 51 
Perspiration, Sensible 51 
Pertussis 560 
Peru, Balsam of 790 
Peruvian bark 793 
Petrolatum 810 
Phagocytosis 751 
Pharyngitis, Acute 335 
Pharyngitis, Chronic 335 
Phenazone 788 
Phenol 810 

Phenol, Glycerite of 800 
Phenyl salicylate 811 
Phenyldimethylpyrazolon 788 
Phosphoric acid 785 
Phosphorus 811 
Phosphorus, Pills of 812 
Phosphorus, Poisoning by 617 
Phototherapy 710 
Phototherapy, Apparatus 711 
Phototherapy, Arc light 711 
Phototherapy, Blue rays 711 
Fhototherapy, Chemical rays 710 
Phototherapy, Dosage of light 711 
Phototherapy, Finsen light 711 
Phototherapy, Mode of treatment 711 
Phototherapy, Nature of light 710 
Phototherapy, Red rays 711 
Phototherapy, Sunlight 711 
Phototherapy, Ultra violet rays 711 
Phototherapy, Violet rays 711 
Phototherapy, White glass interference 711 
Phototherapy, White light 711 
Physical exercise 82 
Physiology 714 
Physostigma 811 
Physostigmata, Tincture 822 
Physostigmine salicylate 811 
Physostigmine sulphate 811 
Phytolacca 811 

Phytolacca, Fluidextract of 799 
Pie, Invalid apple 301 
Piles 381 

Piles during pregnancy 484 
Piles, Homeopathic treatment 683 
Pill, A. B. S. 812 
Pill, Blue 805 
Pill, Evacuant 812 
Pill, Lapatic 812 



Pills 811 

Pills, Blaud's 811 

Pills, Compound cathartic 811 

Pills, Compound laxative 811 

Pills, Lady Webster 811 

Pills of aloes 811 

Pills of aloes and mastic 811 

Pills of asafoetida 811 

Pills of ferrous carbonate 811 

Pills of ferrous iodide 811 

Pills of opium 812 

Pills of phosphorus 812 

Pills of podophyllum, belladonna and capsi- 
cum 812 

Pills of rhubarb, Compound 812 

Pills, Vegetable cathartic 811 

Pilocarpine hydrochloride 811 

Pilocarpine nitrate 811 

Pilocarpus 811 

Pilocarpus, Fluidextract 799 

Pimenta 812 

Pimenta, Oil of 809 

Pimpinella anisum 787 

Pimples, Cream for 57 

Pinkroot 817 

Piper 812 

Piperine 812 

Pipsissewa 792 

Pixliquida 812 

Plants, Causes of poisoning by 619 

Plants, Poisonous 618 

Plants, Protective measures against poison- 
ous 620 

Plasmodium malarise 156 

Plaster, Adhesive 795 

Plaster, Ammoniacum and mercury 795 

Plaster, Belladonna 795 

Plaster, Capsicum 795 

Plaster, Diachylon 795 

Plaster, Lead 795 

Plaster, Mercury 795 

Plaster, Opium 795 

Plasters 795 

Playhouse, The 135 

Pleura 754 

Pleurisy 343 

Pleurisy, Homeopathic treatment 683 

Pleuritis 343 

Plums as a food, Value of 32 

Pneumonia 596 

Pneumonia, Cold applications in 257 

Pneumonia, Early symptoms of 204 

Pneumonia, Hyperstatic 259 

Pneumonia, Lobar 349 

Podophyllum 812 

Podophyllum, Fluidextract 799 

Podophyllum, Resin of 814 

Poison hemlock 637, 794 

Poison ivy, Poisoning by 617 

Poison laurel 639 

Poison root 627 

Poison snakeweed 637 

Poisoning by acetanilid 612 

Poisoning by aconite 613 



INDEX. 



863 



Poisoning by ammonia 613 

Poisoning by antimony 613 

Poisoning by antipyrine 613 

Poisoning by arsenic 613 

Poisoning by atropine 614 

Poisoning by barium salts 614 

Poisoning by belladonna 614 

Poisoning by bichloride of mercury 615 

Poisoning by blue vitriol 618 

Poisoning by buckeye 635 

Poisoning by cantharides 614 

Poisoning by carbolic acid 613 

Poisoning by chloral 614 

Poisoning by chloroform 614 

Poisoning by choke damp 614 

Poisoning by coal gas 614 

Poisoning by cocaine 614 

Poisoning by codeine 614 

Poisoning by colchicum 614 

Poisoning by conium 615 

Poisoning by copper sulphate 615 

Poisoning by corrosive sublimate 615 

Poisoning by creosote 615 

Poisoning by croton oil 615 

Poisoning by cyanide of potash 615 

Poisoning by deadly amanita 620 

Poisoning by digitalis 615 

Poisoning by dyes 616 

Poisoning by elaterium 615 

Poisoning by ergot 615 

Poisoning by ether 615 

Poisoning by false orange amanita 620 

Poisoning by fly agaric 620 

Poisoning by fly amanita 620 

Poisoning by fly fungus 620 

Poisoning by fly killer 620 

Poisoning by fly poison 615 

Poisoning by food 615 

Poisoning by gold 615 

Poisoning by horse-chestnut 635 

Poisoning by hydrocyanic (Prussic) acid 613 

Poisoning by hyoscyamus 616 

Poisoning by ink 616 

Poisoning by iodine 616 

Poisoning by laudanum 616 

Poisoning by laughing gas 616 

Poisoning by lead salts 616 

Poisoning by lobelia 616 

Poisoning by matches 616 

Poisoning by mercury 616 

Poisoning by mineral acids 613 

Poisoning by morphine 616 

Poisoning by mushrooms 616 

Poisoning by nicotine 616 

Poisoning by nitrous oxide 616 

Poisoning by nux vomica 616 

Poisoning by opium 617 

Poisoning by oxalic acid 617 

Poisoning by Paris green 617 

Poisoning by perchloride of mercury 615 

Poisoning by phosphorus 617 

Poisoning by poison ivy 617 

Poisoning by rat poison 617 

Poisoning by red buckeye 635 



Poisoning by silver salts 617 

Poisoning by small buckeye 635 

Poisoning by snake bite 617 

Poisoning by soda 618 

Poisoning by Spanish fly 614 

Poisoning by stings 618 

Poisoning by stramonium 618 

Poisoning by strychnine 618 

Poisoning by sulfonal 618 

Poisoning by tartar emetic 618 

Poisoning by thorn apple 618 

Poisoning by tobacco 618 

Poisoning by water hemlock 636 

Poisoning by white precipitate 618 

Poisoning by white vitriol 618 

Poisoning by wood alcohol 618 

Poisoning by zinc salts 618 

Poisonous plants 618 

Poisonous plants, Causes of poisoning by 619 

Poisonous plants, Protective measures 

against 620 
Poisons and their antidotes 571, 61 
Poisons, Emetics for 612 
Poisons, Irritant 611 
Poisons, Narcotic 611 
Poke root 811 
Polypus of the ear 325 
Polypus of the nose 92, 331 
Polypus of the womb 469 
Pomegranate bark, Decoction of 794 
Pomegranate, Fluidextract of 798 
Pork as a food, Value of 32 
Position, Bad sitting 80 
Position, Bad sleeping 81 
Position, correct standing 81 
Potatoes as food, Value of 32 
Potassium acetate 812 
Potassium and sodium tartrate 812 
Potassium arsenite, Solution of 804 
Potassium bicarbonate 812 
Potassium bitartrate 812 
Potassium bromide 812 
Potassium carbonate 812 
Potassium chlorate 812 
Potassium chlorate, Troches of 824 
Potassium citrate 812 
Potassium citrate, Solution of 804 
Potassium cyanide 812 
Potassium hydroxide 812 
Potassium hydroxide, Solution of 80 
Potassium hypophosphite 813 
Potassium iodide 813 
Potassium iodide ointment 825 
Potassium nitrate 813 
Potassium permanganate 813 
Potassium sulphate 813 
Potassium tartrate 788 
Poultice, Charcoal 792 
Poultice jackets 240 
Poultice, Linseed meal 240 
Poultice, Starch 240 
Poultice, Yeast 240 
Poultices 239 
Poultices, Bread 240 



864 



INDEX. 



Powder, Aromatic 813 

Powder, Compound acetanilid 813 

Powder, Compound chalk 813 

Powder, Compound effervescing 813 

Powder, Dover's 813 

Powder, Gregory's 813 

Powder of glycyrrhiza 813 

Powder of ipecac and opium 813 

Powder of jalap 813 

Powder of licorice, Compound 813 

Powder of morphine, Compound 813 

Powder of oak galls 790 

Powder of 'rhubarb, Compound 813 

Powder, Seidlitz 813 

Powder, Tully's 813 

Powders 813 

Pregnancy 472 

Pregnancy, Care of the teeth during 477 

Pregnancy, Conduct during 475 

Pregnancy, Diet during 475 

Pregnancy, Diseases of 481 

Pregnancy, Dress during 476 

Pregnancy, Exercise during 476 

Pregnancy, False 484 

Pregnancy, Moral influence on 476 

Pregnancy, Signs of 472 

Premature birth 487 

Prematurely born children, Care of 503 

Prepared chalk 792 

Prickly ash 826 

Prickly heat 453 

Prince's pine 792 

Prodromal symptoms 189 

Prolapsus ani, Homeopathic treatment 684 

Prolapsus uteri 468 

Proprietary medicines, Dangers of using 646 

Prostate gland 766 

Pro'teids 30 

Protoplasm 715 

Prune 813 

Prunes, Stewed 301 

Prurigo 453 

Prurigo, Homeopathic treatment 682 

Pruritis vulvae 471 

Prussic acid 785 

Prussic (Hydrocyanic) acid, Poisoning by 613 

Psoas abscess 444 

Pudding, Invalid cup 301 

Pudding, Tapioca cup 301 

Puerperal fever, Homeopathic treatment 684 

Puerperal mania 493 

Puke weed 645 

Pulp of teeth 48 

Pulse, How to feel the 248 

Pulse, Irregular 357 

Pulveres 813 

Pulvis aromaticus 789 

Pumpkin seed 810 

Purgatives 779 

Purgatives, Drastic 779 

Purgatives, Saline 779 

Purgatives, Simple 779 

Purple thorn apple 641 

Putrid sore throat 567 



Pyrethrum 814 
Pyrethrum, Tincture 823 
Pyrogallic acid 814 
Pyrogallol 814 
Pyroxylin 793 
Pyroxylinum 814 

Quassia 814 

Quassia, Extract of 797 

Quassia, Fluidextract of 799 

Quassia, Tincture 823 

Queen's root 818 

Quercus 814 

Quickening 472 

Quicklime a disinfectant 162 

Quillaja 814 

Quillaja, Fluidextract of 799 

Quillaja, Tincture 823 

Quinine 814 

Quinine, Sulphate 814 

Quinsy 338 

Quinsy in children 547 

Quinsy, Homeopathic treatment 681 

Rabies 402 

Rabies, Dumb 403 

Rabies, Means of preventing 157 

Rachitic rosary 529 

Rachitis 529 

Radiotherapy 695 

Radius 726 

Rash, Nettle 450 

Rash, Rose 450 

Rash, Summer 57 

Rash, Tooth 450 

Rashes 450 

Rat, Bite of 601 

Rat poison, Poisoning by 617 

Ration of United States army 42 

Reading on trains, Danger of 104 

Rectified spirit 786 

Rectum 759 

Red buckeye, Poisoning by 635 

Red precipitate 801 

Red puccoon 644 

Red root 644 

Red saunders 815 

Reduced iron 797 

Remittent fever 406 

Remittent fever, Homeopathic treatment 677 

Renal calculi detected by X-ray 701 

Renal congestion 391 

Resin of jalap 814 

Resin of podophyllum 814 

Resin of scammony 814 

Resins 814 

Resorcinol 814 

Respiration, Abdominal 755 

Respiration, Artificial 607 

Respiration, Costal 755 

Respiration, How to count 249 

Respiratory organs, Care of the 77 

Respiratory stimulants, List of 612 

Resuscitation, Sylvester's method 607 



INDEX. 



865 



Resuscitation, When arm is injured 609 

Retina 768 

Rhatany 802 

Rhamnus purshiana 814 

Rheum 814 

Rheumatic fever 432 

Rheumatism, Acute articular 432 

Rheumatism, Diet in 286 

Rheumatism, Homeopathic treatment 684 

Rheumatism, Muscular 435 

Rhododendron maximum 639 

Rhubarb 814 

Rhubarb and soda, Mixture of 806 

Rhubarb, Aromatic syrup of 820 

Rhubarb, Aromatic tincture of 823 

Rhubarb, Compound pills of 812 

Rhubarb, Compound powder of 813 

Rhubarb, Extract of 797 

Rhubarb, Fluidextract of 799 

Rhubarb, Syrup of 820 

Rhubarb, Tincture 823 

Rhus glabra 814 

Rhus glabra, Fluidextract of 799 

Ribs 718 

Ribs, Fracture of the 591 

Rice as a food, Value of 32 

Rice, Parched 297 

Rickets 106, 529 

Rickets, Homeopathic treatment 684 

Ringworm 456 

Ringworm, Homeopathic treatment 684 

Ringworm of the beard 312 

Ringworm of the scalp 311 

Rochelle salts 812 

Roof garden 133 

Roof of the house 130 

Rose, Confection of 793 

Rose, Fluidextract of 799 

Rose laurel 639 

Rose, Oil of 809 

Rose rash 450 

Rose, Red 814 

Rose, Syrup of 820 

Rose, The 347 

Rose. water 789 

Rose water ointment 824 

Rosemary, Oil of 809 

Rosin 814 

Rosin cerate 790, 792 

Rosin cerate, Compound 792 

Round-leaf laurel 639 

Rubbish, Disposal of 131 

Rubefacients 783 

Rubella 566 

Rubeola 565 

Rubus 814 

Rubus, Fluidextract of 799 

Rural insanity 667 

Russian bath 55 

Rye flour as a food, Value of 32 

Saccharated ferrous carbonate 797 
Saffron, Meadow 793 
Safrol 815 



Sage 815 

Salicin 815 

Salicylic acid 785 

Saline waters 707 

Salivation 333 

Salt 817 

Sandalwood, Oil of 809 

Sanguinaria 815 

Sanguinaria canadensis 644 

Sanguinaria, Fluidextract of 799 

Sanguinaria, Tincture 823 

Santalum rubrum 815 

Santonica 815 

Santonin 815 

Santonin, Troches of 824 

Sapo 815 

Saprophytes 150 

Sarcolemma 727 

Sarsaparilla 815 

Sarsaparilla, Compound fluidextract of 799 

Sarsaparilla, Compound syrup of 820 

Sarsaparilla, Fluidextract of 799 

Sassafras 815 

Sassafras, Oil of 809 

Sassafras pith 815 

Sassafras pith, Mucilage 807 

Savine 815 

Savine, Fluidextract of 799 

Savine, Oil of 809 

Scabies 454 

Scalds 597 

Scall defined 456 

Scalp, Itching of the 70 

Scalp massage 69 

Scammony 815 

Scarfskin, The 50 

Scarlatina 563 

Scarlatina, Homeopathic treatment 684 

Scarlet berry 642 

Scarlet fever 563 

Scarlet fever, Early symptoms of 204 

Scarlet fever, Homeopathic treatment 684 

Scarlet fever, Means of preventing 154 

Scarlet fever spread by impure air 86 

Sciatica 437 

Sciatica, Homeopathic treatment 684 

Scoparius 815 

Scopola 815 

Scopola, Extract of 797 

Scopola, Fluidextract of 799 

Scorbutus 531 

Scratches by cat 601 

Screens for doors and windows 133 

Scrofula, Homeopathic treatment 684 

Scurvy 531 

Scurvy, Homeopathic treatment 685 

Scutellaria 815 

Sea bathing 52 

Sea sickness, Homeopathic treatment 685 

Sebaceous glands 762 

Seborrhoea 303 

Sedatives 779 

Seidlitz powder 813 

Seltzer water, Analysis of 708 



866 



INDEX. 



Senega 816 

Senega, Fluidextract 799 

Senega, Syrup of 820 

Senile vertigo 442 

Senna 816 

Senna, Compound infusion of 802 

Senna, Confection of 793 

Senna, Fluidextract of 799 

Senna, Syrup of 820 

Septicaemia 458, 494 

Septicaemia, Means of preventing 157 

Serpentaria 816 

Serpentaria, Fluidextract of 799 

Serpentaria, Tincture 823 

Serum antidiphthericum 816 

Serum of blood 752 

Sewage, Disposal of 130 

Sex a predisposing cause to disease 147 

Shaking palsy, Homeopathic treatment 683 

Sheep laurel 638 

Sheet, How to change the 227 

Sheet, How to pin the 226 

Shortness of breath in pregnancy 482 

Shoulder blade 720 

Shoulder, Dislocation of the 594 

Shoulders, Round 82 

Shower bath 53 

Shower bath, How to make a 53 

Sialagogues 783 

Sick, Care of the 225 

Sight, Defective 100 

Sight of infants 511 

Sight, Sharpness of 101 

Silver cyanide 789 

Silver nitrate 789 

Silver oxide 789 

Silver salts, Poisoning by 617 

Simple cerate 792 

Simple elixir 794 

Simple ointment 824 

Sinapisms 236 

Sitzbath 253 

Skeleton, Appendicular 719 

Skeleton, Axial 719 

Skeleton, Composition of 719 

Skeleton, Diagram of 714 

Skin and its functions 50 

Skin benefited by exercise 111 

Skin, Breathing through the 51 

Skin, Care of the 50 

Skin, Chapped 58 

Skin, Cream for chapped 58 

Skin, Cream for softening the 59 

Skin, Discolored 451 

Skin, Effects of closing the pores of the 51 

Skin food 61 

Skin, Itching of the, Homeopathic treatment 

682 
Skin, Lotion for peeling 59 
Skin, Pores of the 50 
Skin, Structures of 762 
Skull, Base of the 716 
Skull, Bones of the 725 
Skull, Composed of 719 



Skull, Diagram of 716 

Skull, Fracture of the 591 

Skullcap 815 

Sleep in infancy 506 

Sleep, Necessity of 121 

Sleeplessness during pregnancy 483 

Slippery elm 824 

Small buckeye, Poisoning by 635 

Small laurel 639 

Smallpox 408 

Smallpox caused by impure air 86 

Smallpox, Means of preventing 154 

Smith's four chlorides 439 

Snake bite, Poisoning by 617 

Snakebites 599 

Snakeroot, Black 793 

Snakeroot, Senega 816 

Snakeroot, Virginia 816 

Snakes, Poison of 600 

Snakes, Poisonous 600 

Snakeweed 636 

Sneezeweed 643 

Sneezewort 643 

Snuffles 558 

Snuffles, Homeopathic treatment 685 

Soap 56 

Soap bark 814 

Soap, German 815 

Soap, Green 815 

Soap liniment 803 

Soap, Liniment of soft 803 

Soap, Soft 815 

Soap plaster 795 

Soap, White castile 815 

Soda, Poisoning by 618 

Sodii arsenas 789 

Sodium acetate 816 

Sodium arsenate 816 

Sodium arsenate, Solution of 804 

Sodium benzoate 816 

Sodium bicarbonate 816 

Sodium bicarbonate, Troches of 824 

Sodium bisulphite 816 

Sodium borate 816 

Sodium bromide 816 _ 

Sodium chlorate 817 

Sodium chloride 817 

Sodium citrate 817 

Sodium hydroxide 817 

Sodium hydroxide, Solution of 804 

Sodium hypophosphite 817 

Sodium iodide 817 

Sodium nitrate 817 

Sodium nitrite 817 

Sodium phosphate 817 

Sodium phosphate, Compound solution of 804 

Sodium salicylate 817 

Sodium sulphate 817 

Sodium sulphite 817 

Sodium thiosulphate 817 

Soft palate 742 

Soft soap liniment 803 

Solanum dulcamara 642 

Solanum nigrum 641 



INDEX. 



867 



Solanum triflorum 643 

Sole as a food, Value of 32 

Soluble ferric pyrophosphate 797 

Solutions 803 

Soor 544 

Soothing syrup, Danger of using 661 

Soporifics 782 

Sordes in typhoid fever 410 

Sound 773 

Soup as food, Value of 32 

Soups 293 

Spanish flies 791 

Spanish fly, Poisoning by 614 

Sparteine sulphate 817 

Spasm of the glottis, Homeopathic treatment 
685 

Spasms 559 

Spearmint 806 

Spearmint, Oil of 809 

Spearmint, Spirit of 818 

Spearmint water 789 

Spectrum, Composition of 710 

Speech in childhood 511 

Spermaceti 792 

Spigelia 817 

Spigelia, Fluidextract of 799 

Spinal column 720 

Spinal column described 723 

Spinal cord, Diseases of the, Homeopathic 
treatment 679 

Spine, Curvature of the 107 

Spine, Fracture of the 591 

Spine, Irritation of the, Homeopathic treat- 
ment 682 

Spirillum cholerae 151 

Spirits 817 

Spleen 761 

Spleen, Inflammation of the 389 

Spleen, Inflammation of the, Homeopathic 
treatment 681 

Sponge bath 55, 253 

Spoon hunt 639 

Spoon wood 639 

Spotted cowbane 636 

Spotted hemlock 636 

Spotted parsley 636 

Sprains 108, 592 

Sprains, Massage for 272 

Spreading nightshade 643 

Spring water 43 

Sputum cup 244 

Squill 815 

Squill, Compound syrup of 820 

Squill, Fluidextract of 799 

Squill, Syrup of 820 

Squill, Tincture of 823 

Squint 320 

Squinting, Homeopathic treatment 685 

Staff vine 642 

Staggerbush 639 

Staggerweed 643 

Stammering 333 

St. Anthony's fire 499 

Stapes 771 



Staphisagria 818 

Starch, Glycerite of 800 

Starch poultice 240 

Stavesacre 818 

Steam heating 139 

Stearic acid 785 

Stearin 717 

Sterilization of milk 159 

Sterilizing milk 515 

Stiff neck 435 

Stiff neck, Homeopathic treatment 685 

Still, Dr. A. T., founder of osteopathy 687 

Stillingia 818 

Stillingia, Fluidextract of 799 

Stings of insects 598 

Stings, Poisoning by 618 

Stinkweed 637, 641 

Stinkwort 641 

Stitch in the side, Homeopathic treatment 
685 

Stomach 757 

Stomach, Cancer of the 369 

Stomach, Cardiac dilation of 757 

Stomach, Cardiac orifice of the 757 

Stomach, Cramp of the 365 

Stomach, Cramp of the, of children 550 

Stomach, Cramp of the, Homeopathic treat- 
ment 678 

Stomach, Diseases of the 362 

Stomach, Inflammation of the 362 

Stomach, Inflammation of the, Homeopathic 
treatment 681 

Stomach, Ulcer of the 368 

Stomachics 783 

Stomatitis, Aphthous 543 

Stomatitis, Catarrhal 542 

Stomatitis, Mercurial 333 

Stomatitis, Parasitic 544 

Stomatitis, Ulcerative 544 

Stone in the bladder detected by X-ray 701 

Strabismus 320 

Stramonium 818 

Stramonium, Extract of 797 

Stramonium, Fluidextract of 799 

Stramonium ointment 825 

Stramonium, Poisoning by 618 

Stramonium, Tincture 823 

Strangulation, Apparent death from 606 

Strangury 394 

Strawberries as food, Value of 32 

Stronger ammonia water 788 

Stronger orange flower water 788 

Stronger rose water 789 

Strontium bromide 818 

Strontium iodide 818 

Strontium salicylate 818 

Strophanthus 818 

Strophanthus, Tincture 823 

Strychnine 818 

Strychnine, Poisoning by 618 

Stupes 234 

St. Vitus' dance, Homeopathic treatment of 
685 

Stye 314 



868 



INDEX. 



Stye, Aborted 317 

Stye, Homeopathic treatment 685 

Styptics 782, 783 

Styrax 818 

Suburbs, Living in the 126 

Suckling the child, First 496 

Sudorifics 784 

Suet 816 

Suet, boiled in rice 297 

Suffocation, Apparent death from 606 

Sugar, Cane 815 

Sugar diabetes 390 

Suggestion 713 

Suicide 670 

Suicide, Causes of 670 

Suicide, Prevalence of 670 

Sulfonal, Poisoning by 618 

Sulphate of copper an emetic 612 

Sulphate of zinc an emetic 612 

Sulphomethane 819 

Sulphomethylmethane 818 

Sulphur, Confection of 794 

Sulphur iodide 819 

Sulphur, Milk of 819 

Sulphur ointment 825 

Sulphur, Precipitated 819 

Sulphur, Sublimed 819 

Sulphur, Washed 819 

Sulphur waters 707 

Sulphuric acid 785 

Sulphurous acid 785 

Sulphurous acid a disinfectant 162 

Sumach 814 

Sumbul 819 

Sumbul, Extract of 797 

Sumbul, Fluidextract of 799 

Summer complaint 553 

Sunburn 59 

Sunburn, Lotion for 59 

Sunstroke 601 

Superfluous hair 73 

Suppositories 819 

Sutures 725 

Swabs for mouth washing 241 

Swamp sunflower 643 

Sweat glands 51, 762 

Sweat glands, Disorders of the 452 

Sweet birch, Oil of 808 

Sweet flag 791 

Sweet orange peel 790 

Sweet spirit of nitre 817 

Sweetbread 760 

Sylvester's method of resuscitation 607 

Sympathetic disease defined 422 

Symphysis of pubes 724 

Symptoms, List of 206 

Syncope 361 

Syncope, Homeopathic treatment 679 

Synovial membranes 723 

Syringes 244 

Syrups 819 

Table for estimating the day of birth 473 
Table of digestibility of food 33 



Table of eruptive diseases 223 

Table of food values 32 

Table of weight and height 510 

Tachycardia 358 

Talc 821 

Tamarind 821 

Tan 59 

Tannic acid 786 

Tannic acid, Glycerite of 800 

Tannic acid ointment 824 

Tannic acid troches 823 

Tapeworm 557 

Tapioca jelly 297 

Tar 812 

Tar, Oil of 809 

Tar ointment 825 

Tar, Syrup of 820 

Taraxacum 821 

Taraxacum, Extract of 797 

Taraxacum, Fluidextract of 799 

Tartar emetic 788 

Tartar emetic, Poisoning by 618 

Tartaric acid 786 

Teeth 774 

Teeth, Causes of decay 49 

Teeth, Cementum of 48 

Teeth, Cleaning the 49 

Teeth, Dead 50 

Teeth, Deciduous 47 

Teeth, Dentine of 48 

Teeth during pregnancy, Care of 477 

Teeth, Enamel of 48 

Teeth, Examined by X-ray 700 

Teeth, Filling 50 

Teeth, First 774 

Teeth, First set of 47 

Teeth, Milk 774 

Teeth of children 534 

Teeth, Order of appearances of the 774 

Teeth, Permanent 48 

Teeth, Pulp of 48 

Teeth, Structure of 48 

Teeth, Temporary 47 

Teething 534 

Teething, Homeopathic treatment 685 

Temperament and diet 40 

Temperature, Automatic regulation of the 

140 
Temperature, Regulation of 140 
Terebene 821 
Terpin hydrate 821 
Test for acid saliva 479 
Test for alkaline saliva 479 
Tests for alum in baking powder 39 
Tests for adulterated coffee 37 
Tests for artificial butter 38 
Tests for colored milk 38 
Tests for dyed food 37 
Tests for glucose 37 
Tests for hearing 96 
Tests for impure food 36 
Tests for lemon extract 39 
Tests for oleomargarine 38 
Tests for pure butter 38 



INDEX. 



869 



Tests for pure milk 39 

Tests for purity of water 44 

Tests for vanilla 38 

Tetanus 405 

Tetanus, Antitoxin in 705 

Tetanus, Homeopathic treatment 682 

Tetanus, Means of preventing 157 

Tetanus of newborn child 500 

Tetonwort 642 

Tetter 324, 455 

Thermic fever 601 

Thermometer, Bath 54 

Thorax 718 

Thoroughwort 796 

Thorn apple 640 

Thorn apple, Poisoning by 618 

Throat, Clergyman's sore 335 

Throat, Diseases of the 335 

Throat, Putrid sore 567 

Throat, Sore 335 

Throat, Structure of the 741 

Throat, Ulcerated sore, Homeopathic treat- 
ment 686 

Thrombosis 417 

Thrush 544 

Thrush, Homeopathic treatment 685 

Thumb, Dislocation of the 594 

Thumb sucking 537 

Thyme, Oil of 810 

Thymol 821 

Thymol iodide 821 

Tic douloureux 306 

Time of feeding during the first year 513 

Tinctures 821 

Tinea tonsurans 311 

Tissues 715 

Toast, Dry 297 

Toast, Egg 300 

Toast, Milk 298 

Tobacco, Poisoning by 618 

Tolu, Balsam of 790 

Tolu, Syrup of 820 

Tolu, Tincture of 823 

Tongue 773, 774 

Tongue, Inflammation of the 334 

Tongue, Inflammation of the, Homeopathic 
treatment 681 

Tongue, Sore 334 

Tongue-tie 533 

Tonsilitis 336 

Tonsilitis, Early symptoms of 205 

Tonsilitis, Homeopathic treatment 681 

Tonsilitis of children 545 

Tonsils, Inflammation of the 336 

Tonsils, Inflammation of the, in children 544 

Tonsils, Inflammation of the, Homeopathic 
treatment 681 

Tonsils, Location of 742 

Toothache 596 

Toothache, Homeopathic treatment 685 

Tooth rash 450 

Torticollis 435 

Trachea 732, 741 

Trachoma 313 



Tragacanth 823 

Tragacanth, Mucilage of 807 

Trichloracetic acid 786 

Tricophyton 311 

Triticum 823 

Triticum, Fluidextract of 799 

Trituration of elaterin 823 

Troches 823 

Tubercles, Definition of 167 

Tully's powder 813 

Turkish bath 53 

Turn a patient, How to 229 

Turnips as food, Value of 32 

Turpentine, Canadian 821 

Turpentine, Emulsion of oil of 795 

Turpentine liniment 803 

Turpentine, Oil of 810 

Turpeth mineral an emetic 612 

Tympanites defined 412 

Typhoid fever 410 

Typhoid fever, Brand's bath for 231 

Typhoid fever, Early symptoms of 203 

Typhoid fever, Homeopathic treatment of 

685 
Typhoid fever, Means of preventing 155 
Typhus fever 413 

Typhus fever caused by impure air 86 
Typhus fever, Means of preventing 155 

Ulcer of the stomach 368 

Ulcers 445 

Ulcers, Homeopathic treatment 686 

Ulmus 824 

Umbilical hernia 502 

Underclothing, When to change 64 

Unguenta 824 

Unripe fruit, Dangers of eating 40 

Uraemia 393 

Ureter 743, 764 

Urethra 765 

Urinary system 764 

Urine 765 

Urine, Composition of 766 

Urine, Difficulty in voiding, Homeopathic 
treatment 684 

Urine, Excessive flow of 389 

Urine, Incontinence of 395 

Urine, Incontinence of, Homeopathic treat- 
ment 688 

Urine, Preserving specimen of 251 

Urine, Quantity of 766 

Urine, Retention of, after delivery 493 

Urine, Suppression of 394 

Urine, Suppression of, Homeopathic treat- 
ment 685 

Uterine hemorrhage 469 

Utero-gestation 472 

Uterus 766 

Uvaursi 825 

Uva ursi, Fluidextract 799 

Uvula 742 

Uvula, Enlargement of the 339 

Uvula, Enlargement of, Homeopathic treat- 
ment 679 



V 



IXDEX, 



Vaccination 705 

Valerian 825 

Valerian. Ammoniated 823 

Valerian, Fluidextract 799 

Valerian, Tincture 823 

Vallet's mass 805 

Valves of the heart 743 

Valves of veins 748 

Vanilla S25 

Vanilla flavoring. How to examine 38 

Vanilla, Tincture 823 

Varicella 570 

Varicose veins 484 

Varicose veins. Homeopathic treatment 686 

Variola 408 

Vaseline 810 

Veal as a food. Value of 32 

Vegetable cathartic pills 811 

Vegetable soup 294 

Veins 748 

Venison as a food. Value of 32 

Ventilate, How to 8S 

Ventilation of a house 136 

Veratrine 825 

Veratrine ointment 825 

Veratrum 825 

Veratrum. Fluidextract 799 

Veratrum, Tincture 823 

Veratrum viride 793 

Vermicide 777. 784 

Vermiform appendix 759 

Vermifuge 777, 784 

Vertebra, Dorsal 722 

Vertebra, First cervical 720 

Vertebra. First dorsal 718, 722 

Vertebra, Lumbar 722 

Vertebra. Second cervical 720 

Vertebra. Seventh cervical 722 

Vertebra. Twelfth dorsal 722 

Vertigo 442, 603 

Vertigo, Gastric 442, 603 

Vertigo, Homeopathic treatment 679 

Vertigo. Xervous 442, 603 

Vertigo, Ocular 442 

Vertigo. Senile 442 

Vertigo. Stomach 603 

Vesicants 782. 784 

Viburnum, Fluidextract 799 

Virburnum opulus 825 

Viburnum prunifolium 799 

Vichy water. Analysis of 708 

Violet bloom 642 

Visitors in sick room 262 

Visual fraction 102 

Vitriol (blue). Poisoning by 618 

Vitriol (white), Poisoning by 618 

Vocal cords 78 

Vocal cords, Location of 742 

Voice. Care of the 77 

Volatile oils 807 

Voltaic electricity 709 

Vomiting 596 

Vomiting. Homeopathic treatment 686 

Vomiting of childhood 548 



Wahoo 796 . 

Walking a cure for insomnia 115 

Walking, Ease and grace in 114 

Warts 764 t 

Warts. Homeopathic treatment 686 

Warts. To remove 61 

Wasting. Homeopathic treatment 686 

Wasting, Simple 530 

Water 42 

Water a sedative 706 

Water a solvent 706 

Water an anaesthetic 707 

Water an anodyne 707 

Water an emetic 706 

Water and its effects 42 

Water, Bacteria in 43 

Water brash 363 

Water brash. Homeopathic treatment 686 

V ater. Chemical composition of 42 

Water, Effect of boiling 45 

Water. Filtering 45 

Water. Hard 43 

Water hemlock. Poisoning by 636 

Water. Lake 43 

Water. Medicated 

Water, To purify 45, 87 

Water. Rain 42 

Water. Sediment in 45 

Water, Soft 43 

Water. Spring 43 

Water, Tests for purity of 44 

Waters 788 

Watery eye 315 

Wax of the ear 94 

Weaning 514 

Weight of infants 508 

Weight, Table of 510 

Wet nurse. The 512 

Wheat balls 296 

Wheat bread as a food, Value of 32 

Whey 289. 291 

Whiskey 818 

White arsenic 789 

White man's plant 641 

White mouth 544 

White oak 814 

White oak bark 799 

White precipitate 801 

White precipitate. Poisoning by 618 

Whites 465. 470 

Whites. Homeopathic treatment 686 

Whooping cough 560 

Whooping cough caused by impure air 86 

Whooping cough. Emergency treatment 596 

Whooping cough. Means of preventing 155 

Whooping cough, Homeopathic treatment 686 

Wickv 639 

Wild cherry 813 

Wild cherry. Fluidextract 799 

Wild cherry. Infusion 802 

Wild cherry. Syrup 820 

Wind colic 379 

Wine of antimony 825 

Wine of coca 825 



INDEX. 



826 



808 
818 

'1 



Wine of colchicum seed 825 
Wine of ergot 825 
Wine of ipecac 826 
Wine of iron 825 
Wine of iron, Bitter 
Wine of opium 826 
Winter fever 349 
Wintergreen, Oil of 
Wintergreen, Spirit 
Witch-hazel bark 80 
Witch-hazel water 788 
Wodewhistle 637 
Wolf grape 642 
Wolfsbane 786 
Womanhood, Diseases of 461 
Womb 467 

Womb, Cancer of the 468 
Womb, Falling of the 468 

Womb, Falling of the, Homeopathic treat- 
ment 679 
Womb, Inflammation of the 470 
Womb, Polypus of the 469 
Womb, Ulceration of the neck of the 469 
Wood alcohol, Poisoning by 618 
Wood laurel 639 
Woodbine 639 
Woody nightshade 642 
Wool, Value as clothing 62 
Worms 557 

Worms, Homeopathic treatment 686 
Wormseed 815 
Wormseed oil 808 
Wounds, To bathe 261 
Wounds, Treatment of 584, 586, 589 
Wrinkles 60 

Wrinkles, Massage for 273 
Wrinkles, Skin food for 61 
Wrist, Sprained 592 



Xanthoxylum 826 
Xanthoxylum, Fluidextract 
X-ray burn 695 
X-ray, Definition of 695 



'99 



X-ray detection of aneurism 701 

X-ray detection of consumption 701 

X-ray, Detection of foreign bodies in eye 700 

X-ray detection of stone in the bladder 701 

X-ray detection of stone in the kidney 701 

X-ray detection of a swallowed key 697 

X-ray detection of a swallowed pin 697 

X-ray examination of the brain 700 

X-ray examination of curvature of spine 703 

X-ray examination of fractures 701 

X-ray examination, Safety of 695 

X-ray in dentistry 700 

X-rays in medicine and surgery 695 

X-ray in orthopaedic surgery 703 

X-ray in Spanish War 696 

X-ray location of bullets 702 

X-ray measurement of pelvis 703 

X-ray, The fluoroscope 696 

Yeast poultice 240 

Yellow fever 414 

Yellow fever, Homeopathic treatment 686 

Yellow fever, Means of preventing 156 

Yellow jasmine 800 

Yellow jessamine 639 

Yellow jessamine of the South 639 

Yellow spot of the eye 768 

Yellow star 643 

Zea 826 

Zinc acetate 826 

Zinc bromide 826 

Zinc chloride 804 

Zinc iodide 826 

Zinc ointment 825 

Zinc oxide 826 

Zinc phenosulphate 826 

Zinc salts, Poisoning by 618 

Zinc stearate 826 

Zinc stearate ointment 825 

Zinc sulphate 826 

Zinc valerate 826 

Zingiber 826 



EMERGENCY INDEX. 



Acetanilid, Poisoning by 612 
Acids, Burns with 598 
Acids, Poisoning by 613 
Aconite, Poisoning by 614 
Alkalies, Burns with 598 
Ammonia, Poisoning by 613 
Antidotes for poisons 611 
Antimony, Poisoning by 613 
Antipyrine, Poisoning by 613 
Apparent death 606 
Apoplexy 417 
Arm, Fracture of the 590 
Arsenic, Poisoning by 613 
Arteries, Injury to 583 
Artificial respiration 607 
Asthma 596 



Artropine, Poisoning by 614 

Bandages 572 

Belladonna, Poisoning by 614 

Bichloride of mercury, Poisoning by 615 

Bite of cat 601 

Bite of rat 601 

Bites of insects 598 

Bites of snakes 599 

Black eye 319 

Bleeding from lungs 585 

Brain, Concussion of the 423 

Burns 597 

Burns with acids 598 

Burns with alkalies 598 

Burns with lye 598 



8?2 



EMERGENCY INDEX. 



Cantharides, Poisoning by 614 

Carbolic acid, Poisoning by 613 

Carrying injured persons 571 

Cat, Bite of 601 

Cat scratch 601 

Chloral, Poisoning by 614 

Chloroform, Poisoning by 614 

Choking 600 

Clothes catching fire 597 

Coal gas, Poisoning by 614 

Cocaine, Poisoning by 614 

Codeine, Poisoning by 614 

Colchicum, Poisoning by 614 

Colic 549 

Collar bone, Fracture of 591 

Concussion of the brain 423 

Conium, Poisoning by 615 

Contrecoup 604 

Convulsions 559, 595 

Copper sulphate, Poisoning by 615 

Corrosive sublimate, Poisoning by 615 

Cramp 365 

Croton oil, Poisoning by 615 

Croup 555, 596 

Cyanide of potash, Poisoning by 615 

Diarrhoea 596 

Digitalis, Poisoning by 615 

Diphtheria 567 

Dislocations 593 

Domestic emergencies 595 

Drowning 606 

Dyes, Poisoning by 616 

Dysentery 596 



Ear, Foreign bodies in the 96, 325 

Ear, Insects in the 96 

Earache 596 

Emergencies, Domestic 595 

Epilepsy 420 

Ergot, Poisoning by 615 

Ether, Poisoning by 615 

Eye bruises 319 

Eyes, Foreign bodies in the 105 

Fingers, Dislocation of the 594 

Fingers, Fracture of the 592 

Fits 559 

Flooding 469 

Fly killer, Poisoning by 615 

Food, Poisoning by 615 

Fractures 590 

Fracture of collar bone 591 



Hydrocyanic acid, Poisoning by 613 
Hydrophobia 601 

Ink, Poisoning by 616 
Insects, Bites and stings of 598 
Iodine, Poisoning by 616 
Irritant poisons 611 

Jaw, Dislocation of 593 
Jaw, Fracture of 591 

Kneecap, Fracture of 592 

Laudanum, Poisoning by 616 
Laughing gas, Poisoning by 616 
Lead salts, Poisoning by 616 
Leg, Fracture of 590 
Lightning stroke 602 
Lobelia, Poisoning by 616 
Lungs, Bleeding from the 348 

Matches, Poisoning by 616 
Morphine, Poisoning by 616 

Narcotic poisons 611 
Nicotine, Poisoning by 616 
Nosebleed 330 

Opium, Poisoning by 617 
Oxalic acid, Poisoning by 617 

Perchloride of mercury, Poisoning by 615 
Phosphorus, Poisoning by 617 
Poisoning 612 

Poisons and their antidotes 611 
Poison ivy, Poisoning by 617 

Rat bite 601 

Rat poison, Poisoning by 617 

Resuscitation 607 

Ribs, Fracture of the 691 

Scratches by cat 601 

Snakebite 599 

Soda, Poisoning by 618 

Spine, Fractures of the 591 

Sprains 592 

Stings 618 

Strychnine, Poisoning by 618 

Sunstroke 601 

Tartar emetic, Poisoning by 618 
Tobacco, Poisoning by 618 
Toothache 596 



Gas, Poisoning by 614 



Head, Injuries of the 604 
Heat exhaustion 601 
Heatstroke 601 
Hemlock, Poisoning by 636 



Vertigo 603 

Whooping cough, 596 

Wood alcohol, Poisoning by 618 

Wounds 583 

Zinc oxide, Poisoning by 618 



